Basic Information
| Provider Information | |||||||||
| NPI: | 1407261860 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PRICELESS ENDEAVORS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 97115 | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984970115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535887911 | ||||||||
| FaxNumber: | 2533656299 | ||||||||
| Practice Location | |||||||||
| Address1: | 8903 KEY PENINSULA HWY N | ||||||||
| Address2: | |||||||||
| City: | LAKEBAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983499326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538843400 | ||||||||
| FaxNumber: | 2533656299 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/24/2014 | ||||||||
| LastUpdateDate: | 10/13/2014 | ||||||||
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| AuthorizedOfficialLastName: | PRICE | ||||||||
| AuthorizedOfficialFirstName: | BRET | ||||||||
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| AuthorizedOfficialTitleorPosition: | PROVIDER/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 2538843400 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | N.P. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | AP30006026 | WA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | AP30006026 | 01 | WA | LICENSE | OTHER |