Basic Information
Provider Information
NPI: 1326688698
EntityType: 2
ReplacementNPI:  
OrganizationName: THERAPY MANAGEMENT SERVICES, PLLC
LastName:  
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Credential:  
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Mailing Information
Address1: 915 118TH AVE SE STE 110
Address2:  
City: BELLEVUE
State: WA
PostalCode: 980053875
CountryCode: US
TelephoneNumber: 4254509474
FaxNumber: 4254520704
Practice Location
Address1: 275 SW 160TH ST STE 201
Address2:  
City: BURIEN
State: WA
PostalCode: 981663003
CountryCode: US
TelephoneNumber: 2062444263
FaxNumber: 2062448703
Other Information
ProviderEnumerationDate: 01/14/2020
LastUpdateDate: 01/14/2020
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: AYALA
AuthorizedOfficialFirstName: DWAN
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: CREDENTIALING COORDINATOR
AuthorizedOfficialTelephone: 4254509474
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: MRS.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/14/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
332B00000X  Y SuppliersDurable Medical Equipment & Medical Supplies 

No ID Information.


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