Provider Demographics
NPI:1972854370
Name:AGING RESOURCES
Entity Type:Organization
Organization Name:AGING RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:HASKETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-574-5293
Mailing Address - Street 1:7710 NE VANCOUVER MALL DR STE C
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6485
Mailing Address - Country:US
Mailing Address - Phone:360-574-5293
Mailing Address - Fax:360-574-7824
Practice Address - Street 1:7710 NE VANCOUVER MALL DR STE C
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6485
Practice Address - Country:US
Practice Address - Phone:360-574-5293
Practice Address - Fax:360-574-7824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602-412-767302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization