Provider Demographics
NPI:1831522077
Name:SE WA OFFICE OF AGING & LONG TERM CARE
Entity type:Organization
Organization Name:SE WA OFFICE OF AGING & LONG TERM CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-965-0105
Mailing Address - Street 1:PO BOX 8349
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-0349
Mailing Address - Country:US
Mailing Address - Phone:509-965-0105
Mailing Address - Fax:509-965-0221
Practice Address - Street 1:7200 W NOB HILL BLVD
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-1928
Practice Address - Country:US
Practice Address - Phone:509-965-0105
Practice Address - Fax:509-965-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-12
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management