1568967610 NPI number — MRS. JACQUELINE ANNE MEIER LMT

Table of content: MRS. JACQUELINE ANNE MEIER LMT (NPI 1568967610)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568967610 NPI number — MRS. JACQUELINE ANNE MEIER LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MEIER
Provider First Name:
JACQUELINE
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GUILFORD
Provider Other First Name:
JACQUELINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1568967610
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15858 1ST AVE SOUTH
Provider Second Line Business Mailing Address:
STE# A104
Provider Business Mailing Address City Name:
BURIEN
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98148
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-838-0022
Provider Business Mailing Address Fax Number:
206-838-0021

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15858 1ST AVE SOUTH
Provider Second Line Business Practice Location Address:
STE# A104
Provider Business Practice Location Address City Name:
BURIEN
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-838-0022
Provider Business Practice Location Address Fax Number:
206-838-0021
Provider Enumeration Date:
03/29/2018

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: 225700000X , with the licence number:  MA60469523 , 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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