Provider Demographics
NPI:1811231285
Name:THE SPECIAL DELIVERY CO
Entity Type:Organization
Organization Name:THE SPECIAL DELIVERY CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:LACSEUL
Authorized Official - Suffix:
Authorized Official - Credentials:LM
Authorized Official - Phone:425-339-3737
Mailing Address - Street 1:22416 128TH DR NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-9518
Mailing Address - Country:US
Mailing Address - Phone:425-339-3737
Mailing Address - Fax:360-403-9747
Practice Address - Street 1:22416 128TH DR NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-9518
Practice Address - Country:US
Practice Address - Phone:425-339-3737
Practice Address - Fax:360-403-9747
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-24
Last Update Date:2012-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMW00000083176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes176B00000XOther Service ProvidersMidwifeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9801691Medicaid