1952609133 NPI number — NORTHSHORE YOUTH AND FAMILY SERVICES

Table of content: NOUR MAJID BUSSARD LPC (NPI 1144802190)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952609133 NPI number — NORTHSHORE YOUTH AND FAMILY SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHSHORE YOUTH AND FAMILY SERVICES
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:
1952609133
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10309 NE 185TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOTHELL
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98011-3437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-485-6541
Provider Business Mailing Address Fax Number:
425-485-4154

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19201 120TH AVE NE STE 108
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOTHELL
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98011-9523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-485-6541
Provider Business Practice Location Address Fax Number:
425-485-4154
Provider Enumeration Date:
03/11/2011

Additional Information

Authorized Official

Authorized Official Last Name:
ALQUIST
Authorized Official First Name:
MELINDA
Authorized Official Middle Name:
Authorized Official Title or Position:
BILLING SPECIALIST
Authorized Official Telephone Number:
425-485-6541

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  600630032 , 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)





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