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NPI Code Detail

MEDICARE: LUTHERAN COMMUNITY SERVICES NORTHWEST

MEDICARE: LUTHERAN COMMUNITY SERVICES NORTHWEST
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1609078658
Entity Type Code : Organization
Provider Name (Legal Business Name) : LUTHERAN COMMUNITY SERVICES NORTHWEST
Provider Business Mailing Address
First Line : 3321 W KENNEWICK AVE STE 150
Second Line :
City : KENNEWICK
State : WA
Zip : 99336-2968
Country : US
Telephone Number : 509-735-6446
Fax Number : 509-735-6449
Provider Business Practice Location Address
First Line : 3321 W KENNEWICK AVE STE 150
Second Line :
City : KENNEWICK
State : WA
Zip : 99336-2968
Country : US
Telephone Number : 509-735-6446
Fax Number : 509-735-6449
Authorized Official
Title or Position : PRESIDENT
Name : MS. ROBERTA NESTAAS
Credential :
Telephone Number : 206-901-1685
Provider Enumeration Date : 06/01/2007
Last Update Date : 08/22/2020

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Directions to “LUTHERAN COMMUNITY SERVICES NORTHWEST ” Practice Location

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