=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346588910
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABLE NURSE DELEGATION & SVCS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2013
-----------------------------------------------------
Last Update Date | 01/16/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19128 168TH AVE NE
-----------------------------------------------------
City | WOODINVILLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98072-6493
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-398-7862
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19128 168TH AVE NE
-----------------------------------------------------
City | WOODINVILLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98072-6493
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-398-7862
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | RND
-----------------------------------------------------
Name | ALEATHA HALL
-----------------------------------------------------
Credential | BSN, RN
-----------------------------------------------------
Telephone | 425-398-7862
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number | RN0098275
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------