Basic Information
| Provider Information | |||||||||
| NPI: | 1851696785 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | NORTHWEST NASAL SINUS CENTER | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | NORTHWEST FACE | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 N NORTHGATE WAY | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981338916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065252525 | ||||||||
| FaxNumber: | 2065250346 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 CARILLON POINT | ||||||||
| Address2: | |||||||||
| City: | KIRKLAND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4255761700 | ||||||||
| FaxNumber: | 4258277725 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/25/2011 | ||||||||
| LastUpdateDate: | 01/25/2011 | ||||||||
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| AuthorizedOfficialLastName: | ALLEGRA | ||||||||
| AuthorizedOfficialFirstName: | ARLENE | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2068492554 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | MA00021146 | WA | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.