Provider Demographics
NPI:1841461670
Name:OXYGEN SERVICES NORTHWEST
Entity type:Organization
Organization Name:OXYGEN SERVICES NORTHWEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GENEVIEVE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HAWK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-474-1330
Mailing Address - Street 1:20920 61ST AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7506
Mailing Address - Country:US
Mailing Address - Phone:360-474-1330
Mailing Address - Fax:
Practice Address - Street 1:22316 70TH AVE W STE A
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-2184
Practice Address - Country:US
Practice Address - Phone:425-582-2407
Practice Address - Fax:425-361-7533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602785600332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA6306880001Medicare NSC