Provider Demographics
NPI:1477193860
Name:VIVA COLLABORATION LLC
Entity Type:Organization
Organization Name:VIVA COLLABORATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LABARGE
Authorized Official - Suffix:
Authorized Official - Credentials:EAMP
Authorized Official - Phone:321-437-5917
Mailing Address - Street 1:13725 12TH AVE SW APT 387
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1105
Mailing Address - Country:US
Mailing Address - Phone:321-437-5917
Mailing Address - Fax:
Practice Address - Street 1:10703 SE CARR RD
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-5823
Practice Address - Country:US
Practice Address - Phone:321-437-5917
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-14
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty