Organization
CONSEJO COUNSELING AND REFERRAL SERVICE - SHELTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANA BOSCHMA (IS DIRECTOR)
(206) 461-4880
Entity
Organization
Contact information
Practice address
627 W FRANKLIN ST, SHELTON, WA 98584-3504
(360) 763-5610
(360) 462-0449
Mailing address
3808 S ANGELINE ST, SEATTLE, WA 98118-1712
(206) 461-4880
(206) 461-6989
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200488
DBHR SITE LICENSE ID
WA
Enumeration date
07/24/2018
Last updated
03/23/2022
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