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9045 16th Ave Sw Seattle WA 98106-2355 | |
| (206) 762-7207 | |
| (206) 762-7980 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 9045 16th Ave Sw, Seattle, Washington |
| Authorized Official Name and Position | Jill Gresham (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2067627207 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
9045 16th Ave Sw Seattle WA 98106-2355 Ph: (206) 762-7207 | 9045 16th Ave Sw Seattle WA 98106-2355 Ph: (206) 762-7207 |
| NPI Number | 1194975789 |
|---|---|
| Provider Enumeration Date | 09/19/2008 |
| Last Update Date | 09/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194975789 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 17141600 (Washington) | Primary |
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