| Prodigals International | |
|
17320 135th Ave Ne Suite C Woodinville WA 98072-8565 | |
| (425) 419-6016 | |
| Not Available |
| Full Name | Prodigals International |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 17320 135th Ave Ne, Woodinville, Washington |
| Authorized Official Name and Position | Stephen Dulaney (PRESIDENT) |
| Authorized Official Contact | 4254196016 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prodigals International 6619 132nd Ave Ne Pmb 262 Kirkland WA 98033-8627 Ph: () - | Prodigals International 17320 135th Ave Ne Suite C Woodinville WA 98072-8565 Ph: (425) 419-6016 |
| NPI Number | 1861701187 |
|---|---|
| Provider Enumeration Date | 10/04/2010 |
| Last Update Date | 10/04/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861701187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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