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General NPI Number Information
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NPI Number | 1124222559
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Entity Type | Organization
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Legal Business Name | NORTHWEST EVALUATION AND CONSULTATION SERVICES INCORPORATED
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Dates
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Enumeration Date | 06/11/2007
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Last Update Date | 12/14/2007
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Provider Practice Location Address
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Address Line | 5608 17TH STREET CT NE
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City | TACOMA
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State | WA
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Zip | 98422-3446
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Country | US
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Telephone | 253-927-2130
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Fax | 253-952-3049
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Provider Business Mailing Address
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Address Line | 5608 17TH STREET CT NE
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City | TACOMA
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State | WA
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Zip | 98422-3446
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Country | US
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Telephone | 253-927-2130
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Fax | 253-952-3049
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Authorized Official
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Title or Position | ARNP
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Name | DR. JULIA E FANSLOW
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Credential | ARNP, PHD
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Telephone | 253-927-2130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP30004806
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License Number State | WA
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