1598357295 NPI number — THE SPECIAL DELIVERY BIRTH CENTER, LLC

Table of content: (NPI 1598357295)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598357295 NPI number — THE SPECIAL DELIVERY BIRTH CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE SPECIAL DELIVERY BIRTH CENTER, LLC
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:
1598357295
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
102 E HIGHLAND DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98223
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-923-0570
Provider Business Mailing Address Fax Number:
360-403-9747

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
22416 128TH DR. NE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98223
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-923-0570
Provider Business Practice Location Address Fax Number:
360-403-9747
Provider Enumeration Date:
02/04/2021

Additional Information

Authorized Official

Authorized Official Last Name:
FLETCHER
Authorized Official First Name:
CAROLE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE STAFF
Authorized Official Telephone Number:
425-280-8881

Provider Taxonomy Codes

  • Taxonomy code: 261QB0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CBC.FS.61127584 . This is a "FACILITY LICENSE NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 2175564 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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