Organization
CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
Active
Other names
Matt Talbot Center
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE M. THELEN (COMPLIANCE & POLICY ANALYST)
(253) 761-3898
Entity
Organization
Contact information
Practice address
100 23RD AVE S, SEATTLE, WA 98144-2302
(206) 328-5771
Mailing address
2313 3RD AVE, SEATTLE, WA 98121-1711
(206) 328-5771
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
17138600
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1055150
—
WA
Enumeration date
10/22/2012
Last updated
10/15/2018
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