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901 Rainier Avenue S. Seattle WA 98144 | |
| (206) 470-3856 | |
| (206) 470-3857 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 901 Rainier Avenue S., Seattle, Washington |
| Authorized Official Name and Position | Steve Woolworth (VICE PRESIDENT, TREATMENT & REENTRY) |
| Authorized Official Contact | 2067667018 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
7440 W. Marginal Way S. Pioneer Human Services - Contracts Seattle WA 98108-4141 Ph: (206) 768-1990 | 901 Rainier Avenue S. Seattle WA 98144 Ph: (206) 470-3856 |
| NPI Number | 1265554463 |
|---|---|
| Provider Enumeration Date | 04/06/2007 |
| Last Update Date | 10/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265554463 | NPI | - | NPPES |
| 1995083 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 160 (Washington) | Primary |
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