1871634287 NPI number — WARNER & WARNER PLLC

Table of content: (NPI 1871634287)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871634287 NPI number — WARNER & WARNER PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WARNER & WARNER 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:
1871634287
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
601 SE 117TH AVE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98683-5297
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-260-4172
Provider Business Mailing Address Fax Number:
360-260-3955

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 SE 117TH AVE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98683-5297
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-260-4172
Provider Business Practice Location Address Fax Number:
360-260-3955
Provider Enumeration Date:
02/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WARNER
Authorized Official First Name:
DANNY
Authorized Official Middle Name:
GEORGE
Authorized Official Title or Position:
CO-OWNER
Authorized Official Telephone Number:
360-260-4172

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  7644 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: 4411 , 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: 5042510 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5042494 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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