Provider Demographics
NPI:1164924544
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:
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:WONG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-874-3630
Mailing Address - Street 1:34004 16TH AVE S STE 200
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-8951
Mailing Address - Country:US
Mailing Address - Phone:253-874-3630
Mailing Address - Fax:253-838-1670
Practice Address - Street 1:413 N 20TH AVE STE B
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-1807
Practice Address - Country:US
Practice Address - Phone:509-457-8151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health