Provider Demographics
NPI:1760088934
Name:ADMINISTRATIVE RESOURCE PLLC
Entity Type:Organization
Organization Name:ADMINISTRATIVE RESOURCE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEPARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-324-3598
Mailing Address - Street 1:PO BOX 263
Mailing Address - Street 2:
Mailing Address - City:MORTON
Mailing Address - State:WA
Mailing Address - Zip Code:98356-0263
Mailing Address - Country:US
Mailing Address - Phone:360-304-0044
Mailing Address - Fax:360-216-2451
Practice Address - Street 1:101 MAIN AVE
Practice Address - Street 2:
Practice Address - City:MORTON
Practice Address - State:WA
Practice Address - Zip Code:98356-9835
Practice Address - Country:US
Practice Address - Phone:360-304-0044
Practice Address - Fax:360-216-2451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty