Organization
BEHAVIORAL HEALTH RESOURCES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC JENSEN (CONTROLLER)
(360) 236-7170
Entity
Organization
Contact information
Practice address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(360) 704-7170
Mailing address
3857 MARTIN WAY E, OLYMPIA, WA 98506-5268
(360) 704-7170
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
600255953
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7049257
—
WA
05
—
9640525
—
WA
Enumeration date
11/20/2006
Last updated
12/27/2019
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