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General NPI Number Information
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NPI Number | 1669284717
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Entity Type | Organization
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Legal Business Name | AFINNIECO
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Dates
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Enumeration Date | 01/24/2025
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 425 S TACOMA WAY
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City | TACOMA
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State | WA
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Zip | 98402-1207
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Country | US
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Telephone | 405-762-2170
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Fax | 405-762-2170
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Provider Business Mailing Address
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Address Line | 425 S TACOMA WAY
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City | TACOMA
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State | WA
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Zip | 98402-1207
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Country | US
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Telephone | 405-762-2170
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Fax | 405-762-2170
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Authorized Official
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Title or Position | CFO
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Name | MS. ARDRETTA KENYAE JONES I
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Credential | DSP CM
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Telephone | 405-762-2170
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 170100000X
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Taxonomy Name | Ph.D. Medical Genetics
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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