Provider Demographics
NPI:1730504259
Name:NORTHWEST FAMILY SERVICES INSTITUTE
Entity type:Organization
Organization Name:NORTHWEST FAMILY SERVICES INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:RUIZ
Authorized Official - Last Name:CHACON
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:509-667-1926
Mailing Address - Street 1:300 OKANOGAN AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-6940
Mailing Address - Country:US
Mailing Address - Phone:509-667-1926
Mailing Address - Fax:509-888-3001
Practice Address - Street 1:300 OKANOGAN AVE STE 1B
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6940
Practice Address - Country:US
Practice Address - Phone:509-667-1926
Practice Address - Fax:509-888-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health