Provider Demographics
NPI:1093834350
Name:VIRIDIAN ASSOCIATES, LLC
Entity Type:Organization
Organization Name:VIRIDIAN ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:MACHAFFIE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:253-272-5772
Mailing Address - Street 1:PO BOX 1182
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98401-1182
Mailing Address - Country:US
Mailing Address - Phone:253-272-5772
Mailing Address - Fax:253-272-3244
Practice Address - Street 1:707 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-5207
Practice Address - Country:US
Practice Address - Phone:253-272-5772
Practice Address - Fax:253-272-3244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006056363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty