Provider Demographics
NPI:1124245808
Name:FLU SHOTS BY NURSE JANET, INC.
Entity type:Organization
Organization Name:FLU SHOTS BY NURSE JANET, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY AND CHAIRMAN OF THE BOARD
Authorized Official - Prefix:MR
Authorized Official - First Name:G.
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-754-6270
Mailing Address - Street 1:2720 28TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7868
Mailing Address - Country:US
Mailing Address - Phone:360-754-6270
Mailing Address - Fax:
Practice Address - Street 1:2720 28TH AVE SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7868
Practice Address - Country:US
Practice Address - Phone:360-754-6270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA261QC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP00324616OtherRAILROAD MEDICARE PIN
WAP00324616OtherRAILROAD MEDICARE PIN