Provider Demographics
NPI:1356596845
Name:PLANNED PARENTHOOD OF GREATER WASHINGTON AND NORTHERN IDAHO
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF GREATER WASHINGTON AND NORTHERN IDAHO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:EASTLUND
Authorized Official - Suffix:
Authorized Official - Credentials:COO
Authorized Official - Phone:866-904-7721
Mailing Address - Street 1:3901 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-2776
Mailing Address - Country:US
Mailing Address - Phone:866-904-7721
Mailing Address - Fax:509-545-8932
Practice Address - Street 1:828 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4003
Practice Address - Country:US
Practice Address - Phone:866-904-7721
Practice Address - Fax:509-545-8932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA14134207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty