Provider Demographics
NPI:1053392738
Name:VISITING NURSE SERVICES OF THE NORTHWEST
Entity type:Organization
Organization Name:VISITING NURSE SERVICES OF THE NORTHWEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:NEAL
Authorized Official - Middle Name:B
Authorized Official - Last Name:BAUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-778-2400
Mailing Address - Street 1:6100 219TH ST SW
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-2222
Mailing Address - Country:US
Mailing Address - Phone:425-778-2400
Mailing Address - Fax:425-744-2497
Practice Address - Street 1:6100 219TH ST SW
Practice Address - Street 2:SUITE 400
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2222
Practice Address - Country:US
Practice Address - Phone:425-778-2400
Practice Address - Fax:425-744-2497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIS464251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKHH729WAMedicaid
WA920070Medicaid
WA507035Medicare ID - Type Unspecified