Organization
COORDINATED CARE OF WASHINGTON, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELSEY VAN HORN (VICE PRESIDENT, MEDICAID)
(253) 442-1486
Entity
Organization
Contact information
Practice address
1145 BROADWAY, TACOMA, WA 98402-3583
(877) 644-4613
Mailing address
1145 BROADWAY, TACOMA, WA 98402-3583
(877) 644-4613
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
603293815
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2015999
—
WA
Enumeration date
03/23/2015
Last updated
06/16/2025
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