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General NPI Number Information
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NPI Number | 1942857586
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Entity Type | Organization
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Legal Business Name | PANZA
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Dates
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Enumeration Date | 08/19/2019
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 3350 MOTTMAN RD SW
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City | TUMWATER
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State | WA
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Zip | 98512-8244
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Country | US
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Telephone | 360-338-0451
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Fax |
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Provider Business Mailing Address
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Address Line | 3350 MOTTMAN RD SW
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City | TUMWATER
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State | WA
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Zip | 98512-8244
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Country | US
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Telephone | 360-338-0451
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JAYCIE OSTERBERG
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Credential |
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Telephone | 360-338-0451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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