Healthcare Provider Details

I. General information

NPI: 1932726023
Provider Name (Legal Business Name): ESTABLISHING ORDER CHRISTIAN MINISTRIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2020
Last Update Date: 08/16/2020
Certification Date: 08/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7704 189TH STREET CT E
PUYALLUP WA
98375-2435
US

IV. Provider business mailing address

7704 189TH STREET CT E
PUYALLUP WA
98375-2435
US

V. Phone/Fax

Practice location:
  • Phone: 253-283-1786
  • Fax:
Mailing address:
  • Phone: 253-283-1786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. VHALARRIE Y SANDLING
Title or Position: THERAPIST PASTOR
Credential: SUDPT
Phone: 253-283-1786