1811462997 NPI number — CYNTHIA LYNN HANDFORD MSC, LCGC

Table of content: CYNTHIA LYNN HANDFORD MSC, LCGC (NPI 1811462997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811462997 NPI number — CYNTHIA LYNN HANDFORD MSC, LCGC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANDFORD
Provider First Name:
CYNTHIA
Provider Middle Name:
LYNN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MSC, LCGC
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:
1811462997
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/04/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
825 EASTLAKE AVENUE EAST
Provider Second Line Business Mailing Address:
MAIL STOP K2-231
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98109-4405
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-606-1629
Provider Business Mailing Address Fax Number:
206-606-6412

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 EASTLAKE AVENUE EAST
Provider Second Line Business Practice Location Address:
MAIL STOP K2-231
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98109-4405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-606-1629
Provider Business Practice Location Address Fax Number:
206-606-6412
Provider Enumeration Date:
10/04/2018

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: 170300000X , with the licence number:  GT60756933 , 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)





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