Provider Demographics
NPI:1710422753
Name:NORTHWEST BEHAVIORAL GUIDES
Entity Type:Organization
Organization Name:NORTHWEST BEHAVIORAL GUIDES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-504-4848
Mailing Address - Street 1:PO BOX 3792
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98063-3792
Mailing Address - Country:US
Mailing Address - Phone:206-504-4848
Mailing Address - Fax:
Practice Address - Street 1:6420 CALIFORNIA AVE SW APT 302
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1847
Practice Address - Country:US
Practice Address - Phone:206-504-4848
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANONE251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NONEOtherBEHAVIOR TECHNICIAN