Provider Demographics
NPI:1174129399
Name:MUSEUM OF SPECIAL ART
Entity type:Organization
Organization Name:MUSEUM OF SPECIAL ART
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT OF MOSA
Authorized Official - Prefix:MS
Authorized Official - First Name:DORI
Authorized Official - Middle Name:TAYLOR
Authorized Official - Last Name:GUTESON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:206-321-9998
Mailing Address - Street 1:8001 14TH AVE NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-0001
Mailing Address - Country:US
Mailing Address - Phone:206-687-9239
Mailing Address - Fax:
Practice Address - Street 1:8001 14TH AVE NE
Practice Address - Street 2:SUITE A
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-0001
Practice Address - Country:US
Practice Address - Phone:206-687-9239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child