Provider Demographics
NPI:1841753134
Name:NORTHWEST THERAPY SERVICES, LLC.
Entity Type:Organization
Organization Name:NORTHWEST THERAPY SERVICES, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:BARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, CCC-SLP
Authorized Official - Phone:701-568-8255
Mailing Address - Street 1:PO BOX 736
Mailing Address - Street 2:
Mailing Address - City:RAY
Mailing Address - State:ND
Mailing Address - Zip Code:58849
Mailing Address - Country:US
Mailing Address - Phone:701-690-6705
Mailing Address - Fax:701-568-8256
Practice Address - Street 1:24 RAILROAD AVENUE
Practice Address - Street 2:
Practice Address - City:RAY
Practice Address - State:ND
Practice Address - Zip Code:58849
Practice Address - Country:US
Practice Address - Phone:701-690-6705
Practice Address - Fax:701-568-8256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1851781082Medicaid
ND1851781082OtherSANFORD, UHC, MEDICARE