NPI Code Details Logo

NPI 1588367858

NPI 1588367858 : CONNECTIONSWA, LLC : KIRKLAND, WA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1588367858
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    CONNECTIONSWA, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    03/24/2023
-----------------------------------------------------
    Last Update Date     |    04/12/2023
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    11410 NE 122ND WAY BLDG A1 
-----------------------------------------------------
    City                 |    KIRKLAND
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    98034-6945
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    602-416-7600
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2390 E CAMELBACK RD STE 400 
-----------------------------------------------------
    City                 |    PHOENIX
-----------------------------------------------------
    State                |    AZ
-----------------------------------------------------
    Zip                  |    85016-3479
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    623-273-6154
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    PROVIDER NETWORK MANAGEMENT ASSOC
-----------------------------------------------------
    Name                 |     JANICE  TALAS DENNY 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    602-416-7647
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    2084P0800X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatry Physician
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    261QM0801X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.