Provider Demographics
NPI:1487206751
Name:BASELINE DELEGATION LLC
Entity Type:Organization
Organization Name:BASELINE DELEGATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:MOSES
Authorized Official - Middle Name:
Authorized Official - Last Name:MWAURA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-200-6603
Mailing Address - Street 1:11232 SE 315TH CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-5390
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11232 SE 315TH CT
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-5390
Practice Address - Country:US
Practice Address - Phone:206-915-8572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty