1689683930 NPI number — JANICE M SACK-ORY ARNP

Table of content: JANICE M SACK-ORY ARNP (NPI 1689683930)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689683930 NPI number — JANICE M SACK-ORY ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SACK-ORY
Provider First Name:
JANICE
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
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:
1689683930
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34709 9TH AVE S
Provider Second Line Business Mailing Address:
STE B-500
Provider Business Mailing Address City Name:
FEDERAL WAY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98003-6789
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-944-6950
Provider Business Mailing Address Fax Number:
253-661-8603

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34709 9TH AVE S
Provider Second Line Business Practice Location Address:
STE B-500
Provider Business Practice Location Address City Name:
FEDERAL WAY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98003-6789
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-944-6950
Provider Business Practice Location Address Fax Number:
253-661-8603
Provider Enumeration Date:
08/05/2006

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: 363LA2200X , with the licence number:  AP30000117 , 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: 8936934 . This is a "STATE CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0194359 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0160003 . This is a "STATE L&I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 160043862 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 9634502 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com