Provider Demographics
NPI:1770644668
Name:PARADOX NORTHWEST ASSOCIATES, INC
Entity Type:Organization
Organization Name:PARADOX NORTHWEST ASSOCIATES, INC
Other - Org Name:HOMEWATCH CAREGIVERS OF SOUTHWEST WASHINGTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:360-992-5956
Mailing Address - Street 1:205 E 11TH ST
Mailing Address - Street 2:SUITE LL1
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3200
Mailing Address - Country:US
Mailing Address - Phone:360-992-5956
Mailing Address - Fax:360-992-5958
Practice Address - Street 1:205 E 11TH ST
Practice Address - Street 2:SUITE LL1
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3200
Practice Address - Country:US
Practice Address - Phone:360-992-5956
Practice Address - Fax:360-992-5958
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIS-007251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA112372OtherKAISER ID