Healthcare Provider Details

I. General information

NPI: 1316561483
Provider Name (Legal Business Name): COVID RESPONSE PARTNERS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2020
Last Update Date: 06/03/2020
Certification Date: 06/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 14TH AVE E
SEATTLE WA
98112-2103
US

IV. Provider business mailing address

2330 14TH AVE E
SEATTLE WA
98112-2103
US

V. Phone/Fax

Practice location:
  • Phone: 425-298-6629
  • Fax: 833-411-4264
Mailing address:
  • Phone: 425-298-6629
  • Fax: 833-411-4264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code405300000X
TaxonomyPrevention Professional
License Number
License Number State

VIII. Authorized Official

Name: TAYLER MOORE
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 425-583-9289