Organization
QUINAULT CHEMICAL DEPEDENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID A HAGEN CDP (PROGRAM MANAGER)
(360) 276-4405
Entity
Organization
Contact information
Practice address
1505 KLA-OOK-WA DR, TAHOLAH, WA 98587-0219
(360) 276-4405
(360) 276-9991
Mailing address
PO BOX 219, 1505 KLA-OOK-WA DR, TAHOLAH, WA 98587
(360) 276-4405
(360) 276-9991
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992817
—
WA
Enumeration date
04/10/2007
Last updated
03/01/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us