1811355696 NPI number — WJR HEALTH LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811355696 NPI number — WJR HEALTH LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WJR HEALTH LTD
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:
1811355696
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/14/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6523 CALIFORNIA AVE SW
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98136-1833
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-638-0300
Provider Business Mailing Address Fax Number:
307-638-0394

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
605 WOODLAND SQUARE LOOP SE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LACEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98503-1045
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-380-9455
Provider Business Practice Location Address Fax Number:
918-803-0601
Provider Enumeration Date:
02/08/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LEUNG
Authorized Official First Name:
WILFRED
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
312-380-9455

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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