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6990 E Green Lake Way N Suite G Seattle WA 98115 | |
| (206) 558-5479 | |
| (949) 579-2876 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6990 E Green Lake Way N, Seattle, Washington |
| Authorized Official Name and Position | Jeffrey Farbman (DIRECTOR OF BILLING) |
| Authorized Official Contact | 9493012863 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
30310 Rancho Viejo Rd San Juan Capistrano CA 92675-1576 Ph: (206) 558-5479 | 6990 E Green Lake Way N Suite G Seattle WA 98115 Ph: (206) 558-5479 |
| NPI Number | 1902562333 |
|---|---|
| Provider Enumeration Date | 11/10/2021 |
| Last Update Date | 06/07/2024 |
| Certification Date | 06/07/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902562333 | NPI | - | NPPES |
| BHA.FS.61272048 | Other | WA | WASHINGTON STATE DEPARTMENT OF HEALTH |
| 578314 | Other | WA | THE JOINT COMMISSION |
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