| Dba Square One | |
|
16310 Ne 80th St Suite 104 Redmond WA 98052-3861 | |
| (425) 881-7084 | |
| (425) 869-0967 |
| Full Name | Dba Square One |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 16310 Ne 80th St, Redmond, Washington |
| Authorized Official Name and Position | Donald Albright Thomas (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4258817084 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dba Square One 16310 Ne 80th St Suite 104 Redmond WA 98052-3861 Ph: (425) 881-7084 | Dba Square One 16310 Ne 80th St Suite 104 Redmond WA 98052-3861 Ph: (425) 881-7084 |
| NPI Number | 1134283971 |
|---|---|
| Provider Enumeration Date | 12/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134283971 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 17 0060 01 (Washington) | Primary |
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