Healthcare Provider Details

I. General information

NPI: 1255037313
Provider Name (Legal Business Name): TRANADOR CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2023
Last Update Date: 02/01/2023
Certification Date: 01/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 1ST AVE
SEATTLE WA
98104-2210
US

IV. Provider business mailing address

600 1ST AVE
SEATTLE WA
98104-2210
US

V. Phone/Fax

Practice location:
  • Phone: 828-900-0922
  • Fax:
Mailing address:
  • Phone: 828-900-0922
  • Fax: 828-900-0923

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. BENJAMIN EDEM
Title or Position: ADMINISTRATOR
Credential: N/A
Phone: 828-900-0922