1710012547 NPI number — NORTHWEST CENTER - CHILD DEVELOPMENT PROGRAM

Table of content: (NPI 1710012547)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710012547 NPI number — NORTHWEST CENTER - CHILD DEVELOPMENT PROGRAM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHWEST CENTER - CHILD DEVELOPMENT PROGRAM
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:
1710012547
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7272 W MARGINAL WAY S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-285-9140
Provider Business Mailing Address Fax Number:
206-764-8273

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1840 S 144TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATAC
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98168-3702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-285-9140
Provider Business Practice Location Address Fax Number:
206-764-8273
Provider Enumeration Date:
02/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DOLAN
Authorized Official First Name:
LORI
Authorized Official Middle Name:
Authorized Official Title or Position:
CONTROLLER
Authorized Official Telephone Number:
206-285-9140

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1026246 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com