Provider Demographics
NPI:1164838819
Name:PARADOX NORTHWEST ASSOCIATES, INC.
Entity Type:Organization
Organization Name:PARADOX NORTHWEST ASSOCIATES, INC.
Other - Org Name:HOMEWATCH CAREGIVERS OF VANCOUVER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-992-5956
Mailing Address - Street 1:12214 SE MILL PLAIN BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-6019
Mailing Address - Country:US
Mailing Address - Phone:360-992-5956
Mailing Address - Fax:360-992-5958
Practice Address - Street 1:12214 SE MILL PLAIN BLVD STE 201
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-6019
Practice Address - Country:US
Practice Address - Phone:360-992-5956
Practice Address - Fax:360-992-5958
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARSON HOLDINGS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHIS.FS.00000007253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care