Healthcare Provider Details

I. General information

NPI: 1851654651
Provider Name (Legal Business Name): THERAPEUTIC HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2012
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1412 140TH PL NE
BELLEVUE WA
98007-3915
US

IV. Provider business mailing address

1116 SUMMIT AVE
SEATTLE WA
98101-2831
US

V. Phone/Fax

Practice location:
  • Phone: 425-747-7892
  • Fax: 425-747-8348
Mailing address:
  • Phone: 206-323-0930
  • Fax: 206-454-3778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberCP00003627
License Number StateWA

VIII. Authorized Official

Name: SALOSHNI KEELING
Title or Position: BILLING MANAGER
Credential:
Phone: 206-323-0930