Basics Nw, Llc

NPI 1073864849 - Community/Behavioral Health - 251S00000X

NPI Details
NPI 1073864849
Enumeration Date 09/20/2012
Last Updated 09/20/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name MATTHEW JEFFREY MATTHEW
Position EXECUTIVE DIRECTOR
Phone (360) 280-4414
Fax (360) 547-6470
Practice Location
50 SE BLUE HERON LN
SHELTON WA, 98584-7658, US
Phone (360) 280-4414
Fax (360) 547-6470
Business Location
50 SE BLUE HERON LN
SHELTON WA, 98584-7658, US
Phone (360) 280-4414
Fax (360) 547-6470
Toxanomy
Taxonomy Code 251S00000X
License State Washington
License Number CL60302030
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According to our database, Basics Nw, Llc NPI is 1073864849, taxonomy code is 251S00000X and license number is CL60302030, license state is located at Washington. Basics Nw, Llc physically located at 50 Se Blue Heron Ln, Shelton WA, 98584-7658. NPI Number 1033115704 has the healthcare provider type.

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1073864849 NPI number is provided on an as is basis without warranty of any kind. 1073864849 is maintained by the National Plan & Provider Enumeration System. The contents of Basics Nw, Llc are for informational purposes only.