Healthcare Provider Details

I. General information

NPI: 1275329054
Provider Name (Legal Business Name): THERAPEUTIC HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2025
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3025 RUCKER AVE
EVERETT WA
98201-3931
US

IV. Provider business mailing address

5802 RAINIER AVE S
SEATTLE WA
98118-2706
US

V. Phone/Fax

Practice location:
  • Phone: 425-347-5121
  • Fax:
Mailing address:
  • Phone: 206-723-1980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: SEAN POTTER
Title or Position: BILLING MANAGER
Credential:
Phone: 206-323-0930