1689912107 NPI number — BEHNAWA PLLC

Table of content: (NPI 1689912107)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689912107 NPI number — BEHNAWA PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BEHNAWA PLLC
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:
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:
1689912107
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1402 LAKE TAPPS PKWY SE
Provider Second Line Business Mailing Address:
STE 104-288
Provider Business Mailing Address City Name:
AUBURN
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98092-8157
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
702-453-3799
Provider Business Mailing Address Fax Number:
702-453-5741

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1500 AVENUE H
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELY
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89301-2615
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
702-453-3799
Provider Business Practice Location Address Fax Number:
702-453-5741
Provider Enumeration Date:
01/17/2013

Additional Information

Authorized Official

Authorized Official Last Name:
LABRECQUE
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCTS MGR
Authorized Official Telephone Number:
702-453-3799

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  14179 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208M00000X , with the licence number: 14179 , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 14179 . This is a "NV LIC" identifier , issued by the state of ( NV ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com