1083036644 NPI number — PATHWAYS NATURALLY, INC.

Table of content: (NPI 1083036644)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083036644 NPI number — PATHWAYS NATURALLY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATHWAYS NATURALLY, 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:
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:
1083036644
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 32116
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BELLINGHAM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98228-4116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
428-941-4744
Provider Business Mailing Address Fax Number:
855-590-1216

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1313 E MAPLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLINGHAM
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98225-5708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-941-4744
Provider Business Practice Location Address Fax Number:
855-590-1216
Provider Enumeration Date:
01/15/2014

Additional Information

Authorized Official

Authorized Official Last Name:
DEARBORN
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
425-688-8877

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  AP30003328 , 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: G8894047 . This is a "MEDICARE, PTAN" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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