Organization
SOUND
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY DUFF (CREDENTIALING)
(206) 444-3655
Entity
Organization
Contact information
Practice address
204 NE 94TH ST, SEATTLE, WA 98115-2752
(206) 461-4580
Mailing address
6400 SOUTHCENTER BLVD, TUKWILA, WA 98188-2547
(206) 901-2000
(206) 901-2010
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/16/2019
Last updated
04/21/2020
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