| Mindsource Center, Llc | |
|
27023 164th Ave Se Covington WA 98042-8241 | |
| (253) 639-7146 | |
| (253) 639-7145 |
| Full Name | Mindsource Center, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 27023 164th Ave Se, Covington, Washington |
| Authorized Official Name and Position | Caroline Sheppard (DIRECTOR) |
| Authorized Official Contact | 2533500661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mindsource Center, Llc 27023 164th Ave Se Covington WA 98042-8241 Ph: (253) 639-7146 | Mindsource Center, Llc 27023 164th Ave Se Covington WA 98042-8241 Ph: (253) 639-7146 |
| NPI Number | 1477978849 |
|---|---|
| Provider Enumeration Date | 02/21/2014 |
| Last Update Date | 02/21/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477978849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 025 (Washington) | Primary |
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