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1229 W Smith St Kent WA 98032-4317 | |
| (253) 854-0077 | |
| (253) 850-2503 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 1229 W Smith St, Kent, Washington |
| Authorized Official Name and Position | Stephanie M. Thelen (COMPLIANCE & POLICY ANALYST) |
| Authorized Official Contact | 2537613898 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 398 Kent WA 98035-0398 Ph: (253) 854-0077 | 1229 W Smith St Kent WA 98032-4317 Ph: (253) 854-0077 |
| NPI Number | 1841348380 |
|---|---|
| Provider Enumeration Date | 01/08/2007 |
| Last Update Date | 10/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841348380 | NPI | - | NPPES |
| 17112500 | Other | WA | CHEMICAL DEPENDENCY |
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