Provider Demographics
NPI:1194877662
Name:PLANNED PARENTHOOD OF WESTERN WASHINGTON
Entity type:Organization
Organization Name:PLANNED PARENTHOOD OF WESTERN WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PUTNEY
Authorized Official - Suffix:
Authorized Official - Credentials:ANRP
Authorized Official - Phone:360-679-3404
Mailing Address - Street 1:3159 GOLDIE RD
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-2703
Mailing Address - Country:US
Mailing Address - Phone:360-679-3404
Mailing Address - Fax:360-679-4019
Practice Address - Street 1:3159 GOLDIE RD
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-2703
Practice Address - Country:US
Practice Address - Phone:360-679-3404
Practice Address - Fax:360-679-4019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30002032261QA0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility