Organization
BEHAVIORAL HEALTH RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JENSEN (CONTROLLER)
(360) 236-7170
Entity
Organization
Contact information
Practice address
110 W K ST, SHELTON, WA 98584-2939
(360) 426-1696
(360) 427-0357
Mailing address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(360) 704-7170
(360) 709-4374
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
600144953
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1993088
—
WA
Enumeration date
11/13/2006
Last updated
12/27/2019
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