Organization
SIDE STREET CENTRE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA JILL CHRISTENSON (OWNER/ADMINISTRATOR)
(206) 242-4084
Entity
Organization
Contact information
Practice address
445 SW 152ND ST, BURIEN, WA 98166-2208
(206) 242-4084
(206) 242-4084
Mailing address
445 SW 152ND ST, BURIEN, WA 98166-2208
(206) 242-4084
(206) 242-4084
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
603222181
WA
Other
Enumeration date
01/28/2013
Last updated
01/28/2013
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