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General NPI Number Information
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NPI Number | 1063217305
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Entity Type | Organization
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Legal Business Name | EIJAS LLC
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Dates
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Enumeration Date | 02/19/2025
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Last Update Date | 02/19/2025
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Provider Practice Location Address
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Address Line | 7801 59TH AVE W
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City | LAKEWOOD
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State | WA
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Zip | 98499-8571
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Country | US
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Telephone | 253-228-5317
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Fax |
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Provider Business Mailing Address
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Address Line | 7801 59TH AVE W
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City | LAKEWOOD
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State | WA
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Zip | 98499-8571
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Country | US
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Telephone | 253-228-5317
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | JONATHAN PHU-TRUNG NGUYEN
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Credential |
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Telephone | 253-228-5317
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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