Provider Demographics
NPI:1093540791
Name:LK COMPASS HEALTHCARE AGENCY LLC
Entity type:Organization
Organization Name:LK COMPASS HEALTHCARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIRUNGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-399-6821
Mailing Address - Street 1:10115 HOLLY DR APT M203
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-8761
Mailing Address - Country:US
Mailing Address - Phone:425-399-6821
Mailing Address - Fax:
Practice Address - Street 1:10115 HOLLY DR APT M203
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-8761
Practice Address - Country:US
Practice Address - Phone:425-399-6821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Single Specialty