Organization
ENCOPRESIS TREATMENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WINIFRED K WATERBURY (OFFICE MANAGER)
(206) 629-4699
Entity
Organization
Contact information
Practice address
611 MAIN ST, SUITE A, EDMONDS, WA 98020-3096
(425) 640-3227
(425) 640-3478
Mailing address
1824 N. 203RD STREET, SHORELINE, WA 98133
(206) 629-4699
(888) 972-9414
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
602025306
WA
Other
Enumeration date
03/20/2012
Last updated
05/10/2021
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