1528239258 NPI number — HARMONY HEIGHTS AFH

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 1528239258 NPI number — HARMONY HEIGHTS AFH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HARMONY HEIGHTS AFH
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:
1528239258
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
13014 171ST ST E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH HILL
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98374-9577
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-250-2703
Provider Business Mailing Address Fax Number:
425-271-2553

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14318 141ST CT SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RENTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98059-5421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-255-5143
Provider Business Practice Location Address Fax Number:
425-271-2553
Provider Enumeration Date:
03/20/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
YANCEY
Authorized Official First Name:
MARIEBEL
Authorized Official Middle Name:
TUGADE
Authorized Official Title or Position:
OWNER/PROVIDER
Authorized Official Telephone Number:
253-250-2703

Provider Taxonomy Codes

  • Taxonomy code: 311ZA0620X , with the licence number:  750488 , 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)