Provider Demographics
NPI:1194568436
Name:NEXACARE LLC
Entity type:Organization
Organization Name:NEXACARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:RAYMOND
Authorized Official - Last Name:LUMU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-330-7449
Mailing Address - Street 1:15803 BEAR CREEK PKWY UNIT E519
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-4886
Mailing Address - Country:US
Mailing Address - Phone:253-330-7449
Mailing Address - Fax:
Practice Address - Street 1:15803 BEAR CREEK PKWY UNIT E519
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4886
Practice Address - Country:US
Practice Address - Phone:253-330-7449
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care