Healthcare Provider Details

I. General information

NPI: 1235284019
Provider Name (Legal Business Name): ALPHA CENTER FOR TREATMENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10614 BEARDSLEE BLVD SUITE D
BOTHELL WA
98011-3279
US

IV. Provider business mailing address

10614 BEARDSLEE BLVD
BOTHELL WA
98011-3279
US

V. Phone/Fax

Practice location:
  • Phone: 425-483-4664
  • Fax:
Mailing address:
  • Phone: 425-483-4664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateWA

VIII. Authorized Official

Name: SARAH DEALBA
Title or Position: BUSINESS OFFICER
Credential: CFA
Phone: 425-483-4664