Provider Demographics
NPI:1114247442
Name:NEWBORN TRANSITIONAL CARE NURSERY
Entity Type:Organization
Organization Name:NEWBORN TRANSITIONAL CARE NURSERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-422-6557
Mailing Address - Street 1:PO BOX 5066
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5066
Mailing Address - Country:US
Mailing Address - Phone:425-422-6557
Mailing Address - Fax:
Practice Address - Street 1:16006 ASH WAY
Practice Address - Street 2:SUITE 103
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98087-6352
Practice Address - Country:US
Practice Address - Phone:425-422-6557
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-09
Last Update Date:2010-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603012269284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital