Provider Demographics
NPI:1659680239
Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF SNOHOMISH COUNTY
Entity Type:Organization
Organization Name:YOUNG MEN'S CHRISTIAN ASSOCIATION OF SNOHOMISH COUNTY
Other - Org Name:MILL CREEK FAMILY YMCA
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-258-9211
Mailing Address - Street 1:13723 PUGET PARK DR
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-9447
Mailing Address - Country:US
Mailing Address - Phone:425-337-0123
Mailing Address - Fax:
Practice Address - Street 1:13723 PUGET PARK DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-9447
Practice Address - Country:US
Practice Address - Phone:425-337-0123
Practice Address - Fax:425-316-8031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-30
Last Update Date:2010-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty