Healthcare Provider Details

I. General information

NPI: 1386853265
Provider Name (Legal Business Name): NORTHWEST ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 04/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 SPRING CREEK RD
THOMPSON FALLS MT
59873-9432
US

IV. Provider business mailing address

PO BOX 1509
THOMPSON FALLS MT
59873-1509
US

V. Phone/Fax

Practice location:
  • Phone: 406-827-4344
  • Fax: 406-827-5100
Mailing address:
  • Phone: 406-827-4344
  • Fax: 406-827-5100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: DR. MARCEL C CHAPPUIS
Title or Position: CLINICAL DIRECTOR OWNER
Credential: PH.D.
Phone: 406-827-4344