Provider Demographics
NPI:1720203755
Name:SLEEP HEALTH & WELLNESS NW VANCOUVER
Entity Type:Organization
Organization Name:SLEEP HEALTH & WELLNESS NW VANCOUVER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:M
Authorized Official - Last Name:GLENN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-465-9414
Mailing Address - Street 1:2460 NE GRIFFIN OAKS ST
Mailing Address - Street 2:SUITE D1000
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-2672
Mailing Address - Country:US
Mailing Address - Phone:503-352-0700
Mailing Address - Fax:503-352-0705
Practice Address - Street 1:1409 FRANKLIN ST
Practice Address - Street 2:SUITE 103
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-2899
Practice Address - Country:US
Practice Address - Phone:360-213-1300
Practice Address - Fax:360-213-1303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies