Provider Demographics
NPI:1447645676
Name:HEALTHCARE RESOURCE NORTHWEST, LLC
Entity type:Organization
Organization Name:HEALTHCARE RESOURCE NORTHWEST, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:P
Authorized Official - Last Name:GO-SIAYNGCO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:425-585-0364
Mailing Address - Street 1:500 SE EVERETT MALL WAY STE B213
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-8127
Mailing Address - Country:US
Mailing Address - Phone:425-585-0364
Mailing Address - Fax:
Practice Address - Street 1:500 SE EVERETT MALL WAY STE B213
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-8127
Practice Address - Country:US
Practice Address - Phone:425-585-0364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-03
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIHS.FS60540256253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care