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General NPI Number Information
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NPI Number | 1528555109
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Entity Type | Organization
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Legal Business Name | VADIS
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 04/18/2018
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Provider Practice Location Address
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Address Line | 1701 ELM ST E
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City | SUMNER
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State | WA
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Zip | 98390-2112
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Country | US
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Telephone | 253-863-5173
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Fax | 253-863-2040
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Provider Business Mailing Address
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Address Line | 1701 ELM ST E
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City | SUMNER
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State | WA
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Zip | 98390-2112
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Country | US
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Telephone | 253-863-5173
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Fax | 253-863-2040
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Authorized Official
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Title or Position | VICE PRESIDENT OF DEVELOPMENT
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Name | MS. DEANNA WENTZ
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Credential |
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Telephone | 253-863-5173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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