Provider Demographics
NPI:1316161060
Name:HEADWAY NURSING SERVICES
Entity type:Organization
Organization Name:HEADWAY NURSING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANICE
Authorized Official - Middle Name:TUTAAN
Authorized Official - Last Name:ANGLE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:206-380-0042
Mailing Address - Street 1:2130 SHATTUCK AVE SO
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98055-4244
Mailing Address - Country:US
Mailing Address - Phone:425-271-5319
Mailing Address - Fax:425-271-5319
Practice Address - Street 1:2130 SHATTUCK AVE SO
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98055-4244
Practice Address - Country:US
Practice Address - Phone:425-271-5319
Practice Address - Fax:425-271-5319
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA107802311ZA0620X
WARN00117028163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care HomeGroup - Single Specialty