Provider Demographics
NPI:1881279685
Name:OPERATION HEALTHY FAMILY
Entity type:Organization
Organization Name:OPERATION HEALTHY FAMILY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:EFDA
Authorized Official - Phone:509-443-4409
Mailing Address - Street 1:3009 S MOUNT VERNON ST STE 1
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4777
Mailing Address - Country:US
Mailing Address - Phone:509-443-4409
Mailing Address - Fax:
Practice Address - Street 1:2607 S SOUTHEAST BLVD STE B210
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-7614
Practice Address - Country:US
Practice Address - Phone:509-443-4409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPERATION HEALTHY FAMILY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-12
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental