Provider Demographics
NPI:1780034561
Name:J WILLIAMS ENT, LLC
Entity Type:Organization
Organization Name:J WILLIAMS ENT, LLC
Other - Org Name:HOME INSTEAD SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FRANCHISE OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-253-6028
Mailing Address - Street 1:9120 NE VANCOUVER MALL LOOP
Mailing Address - Street 2:SUITE 240
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6353
Mailing Address - Country:US
Mailing Address - Phone:360-253-6028
Mailing Address - Fax:360-253-6029
Practice Address - Street 1:9120 NE VANCOUVER MALL LOOP
Practice Address - Street 2:SUITE 240
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6353
Practice Address - Country:US
Practice Address - Phone:360-253-6028
Practice Address - Fax:360-253-6029
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-13
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIHS.FS.00000031253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA618263800OtherFECA