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General NPI Number Information
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NPI Number | 1801933932
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Entity Type | Organization
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Legal Business Name | CDM SERVICES
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 11818 SE MILL PLAIN BLVD SUITE 415
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City | VANCOUVER
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State | WA
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Zip | 98684-5089
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Country | US
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Telephone | 360-896-9695
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Fax | 360-896-9732
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Provider Business Mailing Address
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Address Line | 11818 SE MILL PLAIN BLVD SUITE 415
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City | VANCOUVER
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State | WA
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Zip | 98684-5089
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Country | US
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Telephone | 360-896-9695
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Fax | 360-896-9732
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. ERIC ERICKSON
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Credential |
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Telephone | 360-896-9695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IS-248 (HOME CARE)
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License Number State | WA
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