Organization
SOUND MENTAL HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL M EISENHAUER CFO, MBA, MA (CHIEF FINANCIAL OFFICER)
(206) 302-2200
Entity
Organization
Contact information
Practice address
1600 E OLIVE ST, SEATTLE, WA 98122-2735
(206) 302-2200
(206) 302-2210
Mailing address
1600 E OLIVE ST, SEATTLE, WA 98122-2735
(206) 302-2200
(206) 302-2210
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1045651
MEDICAID PROVIDER ONE
WA
05
—
1994656
—
WA
Enumeration date
07/30/2007
Last updated
03/25/2010
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