Healthcare Provider Details

I. General information

NPI: 1487700100
Provider Name (Legal Business Name): THE SNOQUALMIE TRIBE CHEMICAL DEPENDENCY PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 03/24/2026
Certification Date: 02/27/2020
Deactivation Date: 02/27/2020
Reactivation Date: 03/24/2026

III. Provider practice location address

4480 TOLT AVE
CARNATION WA
98014
US

IV. Provider business mailing address

PO BOX 969
SNOQUALMIE WA
98065-0969
US

V. Phone/Fax

Practice location:
  • Phone: 425-333-5426
  • Fax: 425-888-5513
Mailing address:
  • Phone: 425-333-5426
  • Fax: 425-333-5513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. MARIE RAMIREZ
Title or Position: SOCIAL SERVICE ADMINISTRATOR
Credential:
Phone: 425-333-5426