Organization
COMMUNITY PSYCHIATRIC CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIRSTEN ANN STASZAK BA, MHP (INTAKE SPECIALIST)
(206) 366-3039
Entity
Organization
Contact information
Practice address
11000 LAKE CITY WAY NE, SEATTLE, WA 98125-6748
(206) 461-3614
Mailing address
11000 LAKE CITY WAY NE, SEATTLE, WA 98125-6748
(206) 461-3614
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
CG60147073
WA
Other
Enumeration date
02/02/2017
Last updated
09/28/2018
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