| Organization Name: | VILLAGE INTEGRATIVE CARE, P.S. |
| NPI Number: | 1558642017 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TARA JOHNIE SHELBY (EXECUTIVE DIRECTOR) |
| Mailing Address: | 6300 9th Ave Ne Ste 300 Seattle |
| State: | WA US |
| Postal Code: | 981158516 |
| Phone Number: | 2063635555 |
| Fax Number: | 2063635533 |
| NPI Enumeration Date: | 08/29/2011 |
| NPI Last Update Date: | 11/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |