=====================================================
General NPI Number Information
=====================================================
NPI Number | 1649585845
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SOUND CARE SERVICES
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/11/2010
-----------------------------------------------------
Last Update Date | 08/11/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 615 W TITUS ST
-----------------------------------------------------
City | KENT
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98032-5749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-290-0467
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4610 S RYAN WAY
-----------------------------------------------------
City | TUKWILA
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98178-2084
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-290-0467
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DNP, ARNP
-----------------------------------------------------
Name | ROSEMARY NDUKA
-----------------------------------------------------
Credential | DNP, ARNP
-----------------------------------------------------
Telephone | 206-290-0467
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number | AP60014569
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------