1871651257 NPI number — FEDERAL CERTIFIED HEARING CENTER, INC

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 1871651257 NPI number — FEDERAL CERTIFIED HEARING CENTER, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FEDERAL CERTIFIED HEARING CENTER, INC
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:
1871651257
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 272
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEDRO WOOLLEY
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98284-0272
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-855-1207
Provider Business Mailing Address Fax Number:
360-855-1407

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 HWY 20 BLDG A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEDRO WOOLLEY
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-855-1207
Provider Business Practice Location Address Fax Number:
360-855-1407
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DANIELS
Authorized Official First Name:
DEBBI
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
360-855-1207

Provider Taxonomy Codes

  • Taxonomy code: 237600000X , with the licence number:  2075 , 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: 0214102 . This is a "DEPT. OF LABOR & INDUSTRI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 9059049 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 148537300 . This is a "OWCP" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0214097 . This is a "DEPT OF LABOR & INDUSTRIE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 0214104 . This is a "DEPT. OF LABOR & INDUSTRI" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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