Healthcare Provider Details

I. General information

NPI: 1629276290
Provider Name (Legal Business Name): INTEGRATIONWORKS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5505 BROOKLYN AVE NE
SEATTLE WA
98105-3517
US

IV. Provider business mailing address

5505 BROOKLYN AVE NE
SEATTLE WA
98105-3517
US

V. Phone/Fax

Practice location:
  • Phone: 206-328-5143
  • Fax: 206-525-5351
Mailing address:
  • Phone: 206-328-5143
  • Fax: 206-525-5351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMA00008947
License Number StateWA

VIII. Authorized Official

Name: MS. KAREN A PETERSEN
Title or Position: PRESIDENT
Credential: CHP, LMP
Phone: 206-328-5143