Provider Demographics
NPI:1356775431
Name:MOLINA HEALTHCARE OF WASHINGTON, INC.
Entity type:Organization
Organization Name:MOLINA HEALTHCARE OF WASHINGTON, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT, HEALTHCARE SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:888-562-5442
Mailing Address - Street 1:PO BOX 4004
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98041-4004
Mailing Address - Country:US
Mailing Address - Phone:800-869-7175
Mailing Address - Fax:
Practice Address - Street 1:21540 30TH DR SE
Practice Address - Street 2:400
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-7015
Practice Address - Country:US
Practice Address - Phone:800-869-7175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-26
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management