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3214 50th St Ct Nw Ste 305 Gig Harbor WA 98335-8587 | |
| (253) 257-1700 | |
| (253) 257-1783 |
| Full Name | |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 3214 50th St Ct Nw Ste 305, Gig Harbor, Washington |
| Authorized Official Name and Position | Jeremiah Shane Dunlap (CEO) |
| Authorized Official Contact | 2532571770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3214 50th St Ct Nw Ste 305 Gig Harbor WA 98335-8587 Ph: (253) 257-1700 | 3214 50th St Ct Nw Ste 305 Gig Harbor WA 98335-8587 Ph: (253) 257-1700 |
| NPI Number | 1972085835 |
|---|---|
| Provider Enumeration Date | 09/06/2018 |
| Last Update Date | 01/30/2025 |
| Certification Date | 01/30/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972085835 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | 146100 (Washington) | Primary |
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