Full Name | |
---|---|
Speciality | Clinic/center - Rehabilitation, Substance Use Disorder |
Location | 15455 65th Ave S, Tukwila, Washington |
Authorized Official Name and Position | Shavon Keller (BILLING SUPERVISOR) |
Authorized Official Contact | 3603539431 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 2429 Longview WA 98632-8486 Ph: (206) 721-5170 | 15455 65th Ave S Tukwila WA 98188 Ph: (206) 721-5170 |
NPI Number | 1538412630 |
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Provider Enumeration Date | 10/26/2012 |
Last Update Date | 07/22/2024 |
Identifier | Type | State | Issuer |
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1538412630 | NPI | - | NPPES |
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