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General NPI Number Information
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NPI Number | 1114247442
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Entity Type | Organization
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Legal Business Name | NEWBORN TRANSITIONAL CARE NURSERY
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 16006 ASH WAY SUITE 103
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City | LYNNWOOD
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State | WA
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Zip | 98087-6352
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Country | US
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Telephone | 425-422-6557
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5066
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City | EVERETT
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State | WA
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Zip | 98206-5066
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Country | US
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Telephone | 425-422-6557
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. WENDY WHITE
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Credential |
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Telephone | 425-422-6557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 284300000X
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Taxonomy Name | Special Hospital
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License Number | 603012269
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License Number State | WA
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