Provider Demographics
NPI:1285943175
Name:KOREAN WOMEN'S ASSOCIATION
Entity type:Organization
Organization Name:KOREAN WOMEN'S ASSOCIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:ANSARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-535-4202
Mailing Address - Street 1:123 E 96TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445-2001
Mailing Address - Country:US
Mailing Address - Phone:253-535-4202
Mailing Address - Fax:253-535-4827
Practice Address - Street 1:123 E 96TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98445-2001
Practice Address - Country:US
Practice Address - Phone:253-535-4202
Practice Address - Fax:253-535-4827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIHS.FS.00000362253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care