MEDICARE: THE NORTHWEST PINNACLE GROUP, INC.

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
1	1041C0700X	Clinical Social Worker	LW00004561	WA

General Provider Information

NPI Number	:	1538164983
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE NORTHWEST PINNACLE GROUP, INC.

Provider Business Mailing Address
First Line	:	8015 SE 28TH ST
Second Line	:	STE 309
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2910
Country	:	US
Telephone Number	:	206-236-1294
Fax Number	:	630-604-9955

Provider Business Practice Location Address
First Line	:	8015 SE 28TH ST
Second Line	:	STE 309
City	:	MERCER ISLAND
State	:	WA
Zip	:	98040-2910
Country	:	US
Telephone Number	:	206-236-1294
Fax Number	:	630-604-9955

Authorized Official
Title or Position	:	CEO
Name	:	RON K FEINBERG
Credential	:	MSW, LICSW
Telephone Number	:	206-236-1294

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	02/10/2012

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