| Organization Name: | NORTHWEST FAMILY HEALTH LLC |
| NPI Number: | 1124133079 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SARAH K WICKENHAGEN (PRESIDENT) |
| Mailing Address: | 1881 Nw 185th Ave Suite 102 Aloha |
| State: | OR US |
| Postal Code: | 970066822 |
| Phone Number: | 5034391539 |
| Fax Number: | 5034398960 |
| NPI Enumeration Date: | 08/20/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |