Healthcare Provider Details

I. General information

NPI: 1538164983
Provider Name (Legal Business Name): THE NORTHWEST PINNACLE GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 02/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8015 SE 28TH ST STE 309
MERCER ISLAND WA
98040-2910
US

IV. Provider business mailing address

8015 SE 28TH ST STE 309
MERCER ISLAND WA
98040-2910
US

V. Phone/Fax

Practice location:
  • Phone: 206-236-1294
  • Fax: 630-604-9955
Mailing address:
  • Phone: 206-236-1294
  • Fax: 630-604-9955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLW00004561
License Number StateWA

VIII. Authorized Official

Name: RON K FEINBERG
Title or Position: CEO
Credential: MSW, LICSW
Phone: 206-236-1294