1245280890 NPI number — COMMUNICATION, LANGUAGE AND SPEECH SERVICES, INC.

Table of content: DAVID FRED HARDY DDS (NPI 1407069958)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245280890 NPI number — COMMUNICATION, LANGUAGE AND SPEECH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNICATION, LANGUAGE AND SPEECH SERVICES, 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:
Provider Other Organization Name Type Code:
6
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:
1245280890
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23224 LANDERS RD SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VASHON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98070-6840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-874-9300
Provider Business Mailing Address Fax Number:
206-374-2533

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
535 DOCK ST STE 104
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98402-4629
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-874-9300
Provider Business Practice Location Address Fax Number:
206-374-2533
Provider Enumeration Date:
05/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HERRINGTON
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
BECKETT
Authorized Official Title or Position:
CLINIC DIRECTOR
Authorized Official Telephone Number:
253-874-9300

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X , with the licence number:  LL00001984 , 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: 7101736 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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