1730362849 NPI number — C4THPOWER/CALKINS & CONNER'S CREATIVE CONNECTIONS

Table of content: (NPI 1730362849)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730362849 NPI number — C4THPOWER/CALKINS & CONNER'S CREATIVE CONNECTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
C4THPOWER/CALKINS & CONNER'S CREATIVE CONNECTIONS
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:
1730362849
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14719 HOLIDAY DRIVE KP N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GIG HARBOR
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98329-5128
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-884-3061
Provider Business Mailing Address Fax Number:
253-313-0036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14719 HOLIDAY DRIVE KP N
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GIG HARBOR
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98329-5128
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-884-3061
Provider Business Practice Location Address Fax Number:
253-313-0036
Provider Enumeration Date:
12/12/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CONNER
Authorized Official First Name:
CHERE
Authorized Official Middle Name:
READING
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
253-884-3061

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 6023878370010001 . This is a "UBI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0890254002 . This is a "GS1" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".