Provider Demographics
NPI:1679755284
Name:REM MEDICAL PROFESSIONAL SERVICES
Entity type:Organization
Organization Name:REM MEDICAL PROFESSIONAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:PAGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-491-1065
Mailing Address - Street 1:190 QUEEN ANNE AVE N
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-4968
Mailing Address - Country:US
Mailing Address - Phone:206-285-5102
Mailing Address - Fax:
Practice Address - Street 1:190 QUEEN ANNE AVE N
Practice Address - Street 2:SUITE 250
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4968
Practice Address - Country:US
Practice Address - Phone:206-285-5102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REM MEDICAL CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty