1730315961 NPI number — AMBITIONS OF WASHINGTON, INC

Table of content: (NPI 1730315961)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730315961 NPI number — AMBITIONS OF WASHINGTON, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMBITIONS OF WASHINGTON, 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:
AMBITIONS
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:
1730315961
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
511 N ARGONNE RD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPOKANE VALLEY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
99212-2878
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
509-321-0414
Provider Business Mailing Address Fax Number:
509-321-1699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
511 N ARGONNE RD STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPOKANE VALLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
99212-2878
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
509-321-0414
Provider Business Practice Location Address Fax Number:
509-321-1699
Provider Enumeration Date:
06/02/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WALSH
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
509-755-3155

Provider Taxonomy Codes

  • Taxonomy code: 320900000X , 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: 925148 . This is a "DSHS PROVIDER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 925218 . This is a "DSHS PROVIDER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 925035 . This is a "DSHS PROVIDER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 925079 . This is a "DSHS PROVIDER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".