Healthcare Provider Details

I. General information

NPI: 1154426815
Provider Name (Legal Business Name): NORTHWEST HEALTHCARE ALLIANCE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 COOKS HILL RD SUITE B
CENTRALIA WA
98531-8100
US

IV. Provider business mailing address

901 HUGH WALLIS RD S
LAFAYETTE LA
70508-2511
US

V. Phone/Fax

Practice location:
  • Phone: 360-807-7776
  • Fax: 360-807-7790
Mailing address:
  • Phone: 337-233-1307
  • Fax: 337-233-5764

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA L. PROFFITT
Title or Position: PRESIDENT
Credential:
Phone: 337-233-1307