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Organization

CREATIVE CHANGE COUNSELING CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KATIE WILSON (ADMIN ASST)
(425) 255-5526
Entity
Organization

Contact information

Practice address
200 S TOBIN ST STE A, RENTON, WA 98057-5338
(425) 255-5526
(425) 255-5523
Mailing address
PO BOX 4158, RENTON, WA 98057-4158
(425) 255-5526
(425) 255-5523

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
CL60152004
WA
251S00000X
Community/Behavioral Health Agency
CL60152004
WA

Other

Enumeration date
02/06/2014
Last updated
02/06/2014
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