1801882725 NPI number — CAROL J HUGHES KING OT

Table of content: CAROL J HUGHES KING OT (NPI 1801882725)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801882725 NPI number — CAROL J HUGHES KING OT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUGHES KING
Provider First Name:
CAROL
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OT
Provider Gender Code:
F

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:
1801882725
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 819
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORTING
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98360-0819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-893-6576
Provider Business Mailing Address Fax Number:
800-661-0688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
710 NW JUNIPER ST
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
ISSAQUAH
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98027-2717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-392-2346
Provider Business Practice Location Address Fax Number:
425-392-0185
Provider Enumeration Date:
09/26/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  OT00000754 , 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: 8396590 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: KI2971 . This is a "BLUE SHIELD VM" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: US0864551 . This is a "AETNA SPECIALIST PIN VM" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 3596KI . This is a "BLUE SHIELD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8419830 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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