Provider Demographics
NPI:1437356102
Name:NORTHWEST CD PROFESSIONALS INC.
Entity Type:Organization
Organization Name:NORTHWEST CD PROFESSIONALS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRITTAIN-LINENKO
Authorized Official - Suffix:
Authorized Official - Credentials:CDP, NCACII, CRC
Authorized Official - Phone:360-737-1994
Mailing Address - Street 1:1515 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98663-3433
Mailing Address - Country:US
Mailing Address - Phone:360-737-1994
Mailing Address - Fax:
Practice Address - Street 1:1515 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98663-3433
Practice Address - Country:US
Practice Address - Phone:360-737-1994
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health