MEDICARE: VISITING NURSE SERVICES OF THE NORTHWEST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	IS464	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053392738
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VISITING NURSE SERVICES OF THE NORTHWEST

Provider Business Mailing Address
First Line	:	6100 219TH ST SW
Second Line	:	SUITE 400
City	:	MOUNTLAKE TERRACE
State	:	WA
Zip	:	98043-2222
Country	:	US
Telephone Number	:	425-778-2400
Fax Number	:	425-744-2497

Provider Business Practice Location Address
First Line	:	6100 219TH ST SW
Second Line	:	SUITE 400
City	:	MOUNTLAKE TERRACE
State	:	WA
Zip	:	98043-2222
Country	:	US
Telephone Number	:	425-778-2400
Fax Number	:	425-744-2497

Authorized Official
Title or Position	:	PRESIDENT & CHIEF EXECUTIVE OFFICER
Name	:	MR. NEAL B BAUM
Credential	:
Telephone Number	:	425-778-2400

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	08/22/2020

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