1255733697 NPI number — MS. ASHLEY MARIE MANZONI B.A./A.A.C.

Table of content: MS. ASHLEY MARIE MANZONI B.A./A.A.C. (NPI 1255733697)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255733697 NPI number — MS. ASHLEY MARIE MANZONI B.A./A.A.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MANZONI
Provider First Name:
ASHLEY
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
B.A./A.A.C.
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:
1255733697
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/17/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5801 23RD DR. W
Provider Second Line Business Mailing Address:
#104
Provider Business Mailing Address City Name:
EVERETT
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-513-8213
Provider Business Mailing Address Fax Number:
425-513-0534

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5801 23RD DR. W
Provider Second Line Business Practice Location Address:
#104
Provider Business Practice Location Address City Name:
EVERETT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-513-8213
Provider Business Practice Location Address Fax Number:
425-513-0534
Provider Enumeration Date:
09/17/2014

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: 171M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com