Provider Demographics
NPI:1003847187
Name:LDS FAMILY SERVICES
Entity type:Organization
Organization Name:LDS FAMILY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:CASEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-228-0074
Mailing Address - Street 1:1201 MONSTER RD SW
Mailing Address - Street 2:SUITE 250
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-2996
Mailing Address - Country:US
Mailing Address - Phone:425-228-0074
Mailing Address - Fax:425-226-2531
Practice Address - Street 1:1201 MONSTER RD SW
Practice Address - Street 2:SUITE 250
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2996
Practice Address - Country:US
Practice Address - Phone:425-228-0074
Practice Address - Fax:425-226-2531
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LDS FAMILY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-06
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA600292374251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare