Provider Demographics
NPI:1093035123
Name:INSTITUTE FOR FAMILY DEVELOPMENT
Entity Type:Organization
Organization Name:INSTITUTE FOR FAMILY DEVELOPMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:
Authorized Official - Last Name:HEKTNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-874-3630
Mailing Address - Street 1:34004 16TH AVE S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8903
Mailing Address - Country:US
Mailing Address - Phone:253-874-3630
Mailing Address - Fax:253-838-1670
Practice Address - Street 1:34004 16TH AVE S
Practice Address - Street 2:SUITE 200
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-8903
Practice Address - Country:US
Practice Address - Phone:253-874-3630
Practice Address - Fax:253-838-1670
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-11
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00010370251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health