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General NPI Number Information
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NPI Number | 1184820771
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Entity Type | Organization
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Legal Business Name | CLUBSTAFFING
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 13008 NE 120TH LN APT R202
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City | KIRKLAND
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State | WA
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Zip | 98034-9302
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Country | US
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Telephone | 425-898-4137
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Fax |
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Provider Business Mailing Address
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Address Line | 13008 NE 120TH LN APT R202
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City | KIRKLAND
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State | WA
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Zip | 98034-9302
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Country | US
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Telephone | 425-898-4137
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Fax |
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Authorized Official
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Title or Position | MT
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Name | MRS. WENDY S FINCH-HOOGAKKER
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Credential | ASCP
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Telephone | 425-898-4137
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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