1588823439 NPI number — MS. LINDA LEE HANBY BS, MFTA, RC

Table of content: LUCAS JAY STOUT (NPI 1578315081)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588823439 NPI number — MS. LINDA LEE HANBY BS, MFTA, RC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANBY
Provider First Name:
LINDA
Provider Middle Name:
LEE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
BS, MFTA, RC
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:
1588823439
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19435 68TH AVE S
Provider Second Line Business Mailing Address:
S108
Provider Business Mailing Address City Name:
KENT
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98032-2102
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-398-2023
Provider Business Mailing Address Fax Number:
253-398-2025

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19435 68TH AVE S STE S108
Provider Second Line Business Practice Location Address:
LINDA HANBY FAMILY THERAPY
Provider Business Practice Location Address City Name:
KENT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98032-2114
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-398-2023
Provider Business Practice Location Address Fax Number:
253-398-2025
Provider Enumeration Date:
06/05/2008

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: 101YM0800X , with the licence number:  RC00035597 , 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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