Provider Demographics
NPI:1093010209
Name:WASHINGTON VOCATIONAL SERVICES
Entity Type:Organization
Organization Name:WASHINGTON VOCATIONAL SERVICES
Other - Org Name:ALYESKA VOCATIONAL SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN VACTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-320-7574
Mailing Address - Street 1:22316 70TH AVE W STE D
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-2184
Mailing Address - Country:US
Mailing Address - Phone:425-774-3338
Mailing Address - Fax:425-744-1555
Practice Address - Street 1:2221 E NORTHERN LIGHTS BLVD STE 108
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4140
Practice Address - Country:US
Practice Address - Phone:907-306-7258
Practice Address - Fax:907-344-7284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-19
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK171M00000X, 251C00000X, 373H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled ServicesGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty