Provider Demographics
NPI:1407854953
Name:SNOHOMISH COUNTY
Entity type:Organization
Organization Name:SNOHOMISH COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DEPARTMENT DEPUTY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-339-8690
Mailing Address - Street 1:3020 RUCKER AVE SUITE 300
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201
Mailing Address - Country:US
Mailing Address - Phone:425-339-8711
Mailing Address - Fax:425-339-5216
Practice Address - Street 1:3020 RUCKER AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201
Practice Address - Country:US
Practice Address - Phone:425-339-8711
Practice Address - Fax:425-339-5216
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-08
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2083P0901X
WAMD00023980251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive MedicineGroup - Single Specialty
No251K00000XAgenciesPublic Health or WelfareGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7407869Medicaid
WA7408404Medicaid
WA7099922Medicaid
WA5900923Medicaid
WA7407885Medicaid
WA7098130Medicaid
WA7408370Medicaid
WA7408362Medicaid
WA7407885Medicaid
WA7407869Medicaid