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General NPI Number Information
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NPI Number | 1093068652
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Entity Type | Organization
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Legal Business Name | NORTHWEST FIRST ASSISTS
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 12/14/2012
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Provider Practice Location Address
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Address Line | 8560 GREENWOOD AVE N 900
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City | SEATTLE
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State | WA
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Zip | 98103-3614
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Country | US
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Telephone | 206-300-4089
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Fax |
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Provider Business Mailing Address
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Address Line | 8560 GREENWOOD AVE N 900
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City | SEATTLE
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State | WA
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Zip | 98103-3614
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Country | US
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Telephone | 206-300-4089
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHAUNA RILEY
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Credential | PA-C
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Telephone | 206-300-4089
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA10004765
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License Number State | WA
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