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1410 Ne 66th St Seattle WA 98115-6744 | |
| (206) 252-4817 | |
| (206) 252-4811 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 1410 Ne 66th St, Seattle, Washington |
| Authorized Official Name and Position | Jill Lewis (SUPERVISOR) |
| Authorized Official Contact | 2062520752 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1410 Ne 66th St Seattle WA 98115-6744 Ph: (206) 252-4817 | 1410 Ne 66th St Seattle WA 98115-6744 Ph: (206) 252-4817 |
| NPI Number | 1265770671 |
|---|---|
| Provider Enumeration Date | 01/18/2013 |
| Last Update Date | 01/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265770671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | RN00053208 (Washington) | Primary |
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