Childs, Matt

Childs, Matt is an sole proprietor health care provider with primary practice located at 1315 11Th Ct Sw , North Bend WA 98045-7989. He recently has only one registered license in Agencies / Supports Brokerage, which is considered as his primary health care specialty. Childs, Matt can be contacted via phone (812) 251-6639.

Contact Information

Primary practice address
1315 11Th Ct Sw North Bend WA 98045-7989
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Agencies / Supports Brokerage 251X00000X 1031895 Washington

Profile Details

NPI number 1134717747
LBN Legal business name Childs, Matt
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 8th, 2021
Last updated Jan 8th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134717747 NPPES
Washington Other 1031895 INSURANCE LICENSE NUMBER
Washington Other 19306485 INSURANCE LICENSE NUMBER

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