Organization
CREATIVE CHANGE COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. FOREST EDWIN WOODLEY AFFILIATED COUNSELOR (CEO)
(425) 255-5526
Entity
Organization
Contact information
Practice address
220 SW BLVD., SUITE B102, RENTON, WA 98057-4158
(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
251B00000X
Case Management Agency
221
WA
251S00000X
Community/Behavioral Health Agency
Primary
17149100
WA
Other
Enumeration date
07/15/2010
Last updated
07/15/2010
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