1770880155 NPI number — HEALTHY BEGINNINGS LACTATION

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 1770880155 NPI number — HEALTHY BEGINNINGS LACTATION

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HEALTHY BEGINNINGS LACTATION
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:
1770880155
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19410 HIGHWAY 99
Provider Second Line Business Mailing Address:
SUITE A-212
Provider Business Mailing Address City Name:
LYNNWOOD
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98036-5102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
559-425-6455
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1530 N 115TH ST
Provider Second Line Business Practice Location Address:
SUITE 205A
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98133-8421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
559-424-6455
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STEVENS
Authorized Official First Name:
KELSEY
Authorized Official Middle Name:
SUSAN
Authorized Official Title or Position:
CO-OWNER
Authorized Official Telephone Number:
559-425-6455

Provider Taxonomy Codes

  • Taxonomy code: 163WL0100X , with the licence number:  RN 00085501 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WL0100X , with the licence number: RN 00123681 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WL0100X , with the licence number: RN 00155625 , 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)