=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588074694
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PLANNED PARENTHOOD OF GREATER WASHINGTON AND NORTH IDAHO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2014
-----------------------------------------------------
Last Update Date | 04/02/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1805 E DIVISION ST
-----------------------------------------------------
City | MOUNT VERNON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98274-4632
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-848-1744
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1509 CORNWALL AVE
-----------------------------------------------------
City | BELLINGHAM
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98225-4521
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-734-9007
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | COO
-----------------------------------------------------
Name | SENDI ACEVES
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 866-904-7721
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | 600033210
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------