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NPI Code Detail

MEDICARE: FOURTH DIMENSION LIVING, FOUNDATIONS

MEDICARE: FOURTH DIMENSION LIVING, FOUNDATIONS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker
2175T00000XPeer Specialist

General Provider Information

NPI Number : 1275480899
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOURTH DIMENSION LIVING, FOUNDATIONS
Provider Business Mailing Address
First Line : 416 ROAD 34
Second Line :
City : PASCO
State : WA
Zip : 99301-4630
Country : US
Telephone Number : 509-412-4196
Fax Number :
Provider Business Practice Location Address
First Line : 720 W COURT ST
Second Line :
City : PASCO
State : WA
Zip : 99301-4178
Country : US
Telephone Number : 509-412-4196
Fax Number :
Authorized Official
Title or Position : CO-FOUNDER, PROGRAM DIRECTOR
Name : ELIZABETH C GREENAWAY
Credential : M.S.
Telephone Number : 509-412-4196
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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Directions to “FOURTH DIMENSION LIVING, FOUNDATIONS ” Practice Location

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