Provider Demographics
NPI:1720028988
Name:MEIER CLINICS OF CALIFORNIA INC
Entity Type:Organization
Organization Name:MEIER CLINICS OF CALIFORNIA INC
Other - Org Name:MEIER CLINICS WASHINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NAT. EX. ASST.
Authorized Official - Prefix:
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWPORT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-653-1717
Mailing Address - Street 1:22232 17TH AVE SE
Mailing Address - Street 2:SUITE 312
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7430
Mailing Address - Country:US
Mailing Address - Phone:630-653-1717
Mailing Address - Fax:630-653-7926
Practice Address - Street 1:22232 17TH AVE SE
Practice Address - Street 2:SUITE 312
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-7430
Practice Address - Country:US
Practice Address - Phone:630-653-1717
Practice Address - Fax:630-653-7926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-07
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00044759101Y00000X
WARC00044760101Y00000X
WALH00005033101YM0800X
WAPY00002496103TC0700X
WAPY00001807103TC0700X
WAPY00001469103TC0700X
WAPY00003289103TC0700X
WAPY00002604103TC0700X
WAPY00003255103TC0700X
WALW000064351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB05528Medicare PIN