1700132735 NPI number — CARE TRANSITIONS NORTHWEST LLC

Table of content: (NPI 1700132735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700132735 NPI number — CARE TRANSITIONS NORTHWEST LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARE TRANSITIONS NORTHWEST 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:
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:
1700132735
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PMB 218 13500 SW PACIFIC HWY
Provider Second Line Business Mailing Address:
STE 58
Provider Business Mailing Address City Name:
TIGARD
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97223-4803
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-680-2355
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11850 SW GREENBURG RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97223-6451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-680-2355
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/27/2012

Additional Information

Authorized Official

Authorized Official Last Name:
CARNEY
Authorized Official First Name:
COLEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
CASE MANAGER
Authorized Official Telephone Number:
503-680-2355

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X , with the licence number:  RN00049377 , 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: 163WCO400X . This is a "RN CASE MANAGER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: RN00049377 . This is a "WASHINGTON BOARD OF NURSING" identifier , issued by the state of ( OR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com