1871651257 NPI number — FEDERAL CERTIFIED HEARING CENTER, INC

Table of content: (NPI 1871651257)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871651257 NPI number — FEDERAL CERTIFIED HEARING CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FEDERAL CERTIFIED HEARING CENTER, INC
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:
FEDERAL CERTIFIED HEARING
Provider Other Organization Name Type Code:
3
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:
1871651257
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 272
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEDRO WOOLLEY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98284-0272
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-855-1207
Provider Business Mailing Address Fax Number:
360-855-1407

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 HWY 20 BLDG A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEDRO WOOLLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-855-1207
Provider Business Practice Location Address Fax Number:
360-855-1407
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DANIELS
Authorized Official First Name:
DEBBI
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
360-855-1207

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  2075 , 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: 0214102 . This is a "DEPT. OF LABOR & INDUSTRI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 9059049 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 148537300 . This is a "OWCP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0214097 . This is a "DEPT OF LABOR & INDUSTRIE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0214104 . This is a "DEPT. OF LABOR & INDUSTRI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com