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202 N Division St Auburn WA 98001-4939 | |
(253) 833-7711 | |
Not Available |
Full Name | |
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Speciality | Psychiatric Unit |
Location | 202 N Division St, Auburn, Washington |
Authorized Official Name and Position | Vincent Schmitz (CFO, SENIOR VP) |
Authorized Official Contact | 2534598000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 5299 Ms: 737-2-ccia Tacoma WA 98415-0299 Ph: (253) 459-8002 | 202 N Division St Auburn WA 98001-4939 Ph: (253) 833-7711 |
NPI Number | 1770579534 |
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Provider Enumeration Date | 09/27/2005 |
Last Update Date | 10/15/2012 |
Medicare PECOS PAC ID | 7719899897 |
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Medicare Enrollment ID | O20120907000362 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770579534 | NPI | - | NPPES |
2022468 | Medicaid | WA |
Taxonomy | Type | License (State) | Status |
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273R00000X | Psychiatric Unit | (Washington) | Primary |
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