1912396912 NPI number — NORTHWEST HEALTH AND SAFETY INC

Table of content: (NPI 1912396912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912396912 NPI number — NORTHWEST HEALTH AND SAFETY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NORTHWEST HEALTH AND SAFETY 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:
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:
1912396912
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/13/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6300 NE ST JAMES RD
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
VANCOUVER
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98663-1494
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-737-8910
Provider Business Mailing Address Fax Number:
360-737-4144

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6300 NE ST JAMES RD
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
VANCOUVER
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98663-1494
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-737-8910
Provider Business Practice Location Address Fax Number:
360-737-4144
Provider Enumeration Date:
01/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
ROYSE
Authorized Official First Name:
JASON
Authorized Official Middle Name:
MICHAEL
Authorized Official Title or Position:
PRESIDENT/GM
Authorized Official Telephone Number:
360-737-8910

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 390526 . This is a "SSPS PROVIDER NUMBER" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1119176 . This is a "PROVIDER ONE ID" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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