PARADISE WOUND HEALING PROFESSIONALS PLLC NPI 1285750901

NPI Information

NPI: 1285750901
Provider Name: PARADISE WOUND HEALING PROFESSIONALS, PLLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1119 HIGHLAND AVENUE
SUITE 7
CLARKSTON, WA
ZIP 99403
Phone: (509) 758-1119
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PARADISE WOUND HEALING PROFESSIONALS, PLLC is a specialist in Clarkston, WA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. PARADISE WOUND HEALING PROFESSIONALS, PLLC NPI is 1285750901. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1119 HIGHLAND AVENUE
SUITE 7
CLARKSTON, WA
ZIP 99403-836
Phone: (509) 758-1119
Fax: (509) 758-1140

The provider's authorized official is Alex C Town .
The authorized official title is Cfo and has the following contact phone number (509) 758-4667.

The enumeration date for this NPI number is 3/22/2007 and was last updated on 3/20/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		602411261	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1377714	MEDICARE PIN	IDAHO
2	8808417	MEDICARE PIN	WASHINGTON
3	DJVB5	OTHER		BLUE CROSS OF IDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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