Provider Demographics
NPI:1679720932
Name:NORTH PUGET SOUND CENTER FOR SLEEP DISORDERS
Entity Type:Organization
Organization Name:NORTH PUGET SOUND CENTER FOR SLEEP DISORDERS
Other - Org Name:SOUND CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:JO
Authorized Official - Last Name:GREENSHIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:425-740-4176
Mailing Address - Street 1:1728 W MARINE VIEW DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-2094
Mailing Address - Country:US
Mailing Address - Phone:425-740-4176
Mailing Address - Fax:425-252-6642
Practice Address - Street 1:1728 W MARINE VIEW DR
Practice Address - Street 2:SUITE 200
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-2094
Practice Address - Country:US
Practice Address - Phone:425-740-4176
Practice Address - Fax:425-252-6642
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH PUGET SOUND CENTER FOR SLEEP DISORDERS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602385287332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA3582NOOtherREGENCE BLUE CROSS BLUE SHIELD