Provider Demographics
NPI:1518361278
Name:KLEIN, VIRGINIA M (MBA HR)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:M
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MBA HR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 23RD DR W
Mailing Address - Street 2:#104
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-1587
Mailing Address - Country:US
Mailing Address - Phone:425-512-2567
Mailing Address - Fax:
Practice Address - Street 1:3028 WETMORE AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4018
Practice Address - Country:US
Practice Address - Phone:425-512-2567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60491860171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator