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23200 100th Ave W Edmonds WA 98020-5020 | |
(425) 431-5825 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 23200 100th Ave W, Edmonds, Washington |
Authorized Official Name and Position | Beratta Gomillion (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2063627282 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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17018 15th Ave Ne Shoreline WA 98155-5126 Ph: (206) 362-7282 | 23200 100th Ave W Edmonds WA 98020-5020 Ph: (425) 431-5825 |
NPI Number | 1023197795 |
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Provider Enumeration Date | 11/03/2006 |
Last Update Date | 06/14/2013 |
Identifier | Type | State | Issuer |
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1023197795 | NPI | - | NPPES |
1994029 | Medicaid | WA |
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