| Organization Name: | MOBILEHEALTHCAREPROVIDERSNORTHWEST |
| NPI Number: | 1487060901 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARY BUCKLAND (PRESIDENT/CEO) |
| Mailing Address: | 2909 Se Village Loop Vancouver |
| State: | WA US |
| Postal Code: | 986838108 |
| Phone Number: | 3609802441 |
| Fax Number: | 3608310047 |
| NPI Enumeration Date: | 07/03/2014 |
| NPI Last Update Date: | 07/03/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251V00000X |
| License Number: | 603288428 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Voluntary or Charitable |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |