Provider Demographics
NPI:1194728907
Name:HILLCREST INVESTMENTS, LC
Entity type:Organization
Organization Name:HILLCREST INVESTMENTS, LC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:N
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-775-6457
Mailing Address - Street 1:7500 212TH ST SW
Mailing Address - Street 2:STE 209
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-7617
Mailing Address - Country:US
Mailing Address - Phone:425-775-6547
Mailing Address - Fax:425-778-2797
Practice Address - Street 1:425 SW 41ST ST
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4926
Practice Address - Country:US
Practice Address - Phone:425-291-9200
Practice Address - Fax:425-291-9300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00002929235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA506538AMedicare ID - Type Unspecified