Provider Demographics
NPI:1689690034
Name:ALPHA NURSING AND SERVICES INCORPORATED
Entity Type:Organization
Organization Name:ALPHA NURSING AND SERVICES INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:PETER
Authorized Official - Last Name:KORZYNEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-357-1790
Mailing Address - Street 1:10530 19TH AVE SE
Mailing Address - Street 2:STE 201
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-4282
Mailing Address - Country:US
Mailing Address - Phone:425-357-1790
Mailing Address - Fax:425-357-1749
Practice Address - Street 1:10530 19TH AVE SE
Practice Address - Street 2:STE 201
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-4282
Practice Address - Country:US
Practice Address - Phone:425-357-1790
Practice Address - Fax:425-357-1790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-15
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIS-210251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9042177Medicaid
WA9042177Medicaid