1003894957 NPI number — LONGVIEW ANESTHESIOLOGY GROUP, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003894957 NPI number — LONGVIEW ANESTHESIOLOGY GROUP, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LONGVIEW ANESTHESIOLOGY GROUP, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003894957
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 24801
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98124-0801
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-407-1500
Provider Business Mailing Address Fax Number:
425-407-1112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
625 9TH AVE STE 150
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LONGVIEW
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98632-2467
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-442-7900
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHEN
Authorized Official First Name:
STAN
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
360-442-7900

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com