Provider Demographics
NPI: | 1205151701 |
---|---|
Name: | CODAS PLUS |
Entity type: | Organization |
Organization Name: | CODAS PLUS |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | MANAGER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | LUANNE |
Authorized Official - Middle Name: | LANI |
Authorized Official - Last Name: | CONNER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 360-576-7777 |
Mailing Address - Street 1: | 800 NE TENNEY RD |
Mailing Address - Street 2: | SUITE 110 PMB 433 |
Mailing Address - City: | VANCOUVER |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98685-2831 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 360-576-7777 |
Mailing Address - Fax: | 360-258-3140 |
Practice Address - Street 1: | 800 NE TENNEY RD |
Practice Address - Street 2: | SUITE 110 PMB 433 |
Practice Address - City: | VANCOUVER |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98685-2831 |
Practice Address - Country: | US |
Practice Address - Phone: | 360-576-7777 |
Practice Address - Fax: | 360-258-3140 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-03-29 |
Last Update Date: | 2010-03-29 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WA | 602387851 | 171R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 171R00000X | Other Service Providers | Interpreter | Group - Single Specialty |