Provider Demographics
NPI:1588207039
Name:KOREAN WOMEN'S ASSOCIATION
Entity Type:Organization
Organization Name:KOREAN WOMEN'S ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HWA JA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-538-8341
Mailing Address - Street 1:123 E 96TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445-2001
Mailing Address - Country:US
Mailing Address - Phone:425-591-2331
Mailing Address - Fax:253-535-4827
Practice Address - Street 1:123 E 96TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445-2001
Practice Address - Country:US
Practice Address - Phone:425-591-2331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1113863Medicaid