1427173731 NPI number — MS. JOAN TAUSCH DUROE

Table of content: MS. JOAN TAUSCH DUROE (NPI 1427173731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427173731 NPI number — MS. JOAN TAUSCH DUROE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUROE
Provider First Name:
JOAN
Provider Middle Name:
TAUSCH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TAUSCH
Provider Other First Name:
JOAN
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.W.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1427173731
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1818 WESTLAKE AVE N
Provider Second Line Business Mailing Address:
SUITE 312
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98109-2777
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-284-5325
Provider Business Mailing Address Fax Number:
206-726-0661

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1818 WESTLAKE AVE N
Provider Second Line Business Practice Location Address:
SUITE 312
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98109-2777
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-284-5325
Provider Business Practice Location Address Fax Number:
206-726-0661
Provider Enumeration Date:
03/20/2007

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: 1041C0700X , with the licence number:  LW00004698 , 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: DU0030 . This is a "REGENCE BLUE SHIELD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 143717 . This is a "PREMERA BLUE CROSS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: LW00004698 . This is a "STATE CLINICAL SOCIAL WOR" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: ABECSW 22296 . This is a "AMERICAN BOARD OF EXAMINE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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