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General NPI Number Information
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NPI Number | 1114782414
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Entity Type | Organization
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Legal Business Name | PEOPLE OF COLOR AGAINST AIDS NETWORK
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Dates
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Enumeration Date | 02/15/2024
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Last Update Date | 05/06/2026
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Provider Practice Location Address
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Address Line | 1010 S 336TH ST STE 330
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7354
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Country | US
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Telephone | 206-653-9353
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Fax | 206-934-1515
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Provider Business Mailing Address
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Address Line | 1010 S 336TH ST STE 330
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City | FEDERAL WAY
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State | WA
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Zip | 98003-7354
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Country | US
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Telephone | 206-653-9353
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Fax | 206-934-1515
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Authorized Official
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Title or Position | HEALTHCARE MANAGER
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Name | MR. CHRIS L PORTER
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Credential |
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Telephone | 206-653-9353
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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