Provider Demographics
NPI:1982158283
Name:SOUND MIND SOUND BODY NURSE DELEGATION SERVICES, INC.
Entity Type:Organization
Organization Name:SOUND MIND SOUND BODY NURSE DELEGATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARRAH MAY
Authorized Official - Middle Name:CATOLICO
Authorized Official - Last Name:MIRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-228-4920
Mailing Address - Street 1:13517 5TH AVENUE CT S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-4711
Mailing Address - Country:US
Mailing Address - Phone:253-228-4920
Mailing Address - Fax:253-238-8722
Practice Address - Street 1:13517 5TH AVENUE CT S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-4711
Practice Address - Country:US
Practice Address - Phone:253-228-4920
Practice Address - Fax:253-238-8722
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00149470163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty