| Alta Vista School | |
|
1950 Pottery Ave S124 Port Orchard WA 98366-2501 | |
| (360) 900-7190 | |
| Not Available |
| Full Name | Alta Vista School |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1950 Pottery Ave S124, Port Orchard, Washington |
| Authorized Official Name and Position | Ashley Ruiz (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3609007190 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alta Vista School 1950 Pottery Ave S124 Port Orchard WA 98366-2590 Ph: (360) 900-7190 | Alta Vista School 1950 Pottery Ave S124 Port Orchard WA 98366-2501 Ph: (360) 900-7190 |
| NPI Number | 1538726252 |
|---|---|
| Provider Enumeration Date | 05/29/2019 |
| Last Update Date | 07/10/2024 |
| Certification Date | 07/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538726252 | NPI | - | NPPES |
| 2142431 | Medicaid | WA |
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