Provider Demographics
NPI:1023868635
Name:ESSENCE HEALTH AND RESEARCH FOUNDATION
Entity type:Organization
Organization Name:ESSENCE HEALTH AND RESEARCH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:COOMES
Authorized Official - Suffix:
Authorized Official - Credentials:DCN
Authorized Official - Phone:425-505-3090
Mailing Address - Street 1:22845 SE 1ST PL APT 405
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-5038
Mailing Address - Country:US
Mailing Address - Phone:425-505-3090
Mailing Address - Fax:
Practice Address - Street 1:22845 SE 1ST PL APT 405
Practice Address - Street 2:
Practice Address - City:SAMMAMISH
Practice Address - State:WA
Practice Address - Zip Code:98074-5038
Practice Address - Country:US
Practice Address - Phone:425-505-3090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-26
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service