Healthcare Provider Details

I. General information

NPI: 1780756080
Provider Name (Legal Business Name): THERAPEUTIC HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 05/07/2024
Certification Date: 05/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 MARTIN LUTHER KING JR WAY S
SEATTLE WA
98144-4801
US

IV. Provider business mailing address

5802 RAINIER AVE S
SEATTLE WA
98118-2706
US

V. Phone/Fax

Practice location:
  • Phone: 206-322-7676
  • Fax: 206-726-7585
Mailing address:
  • Phone: 206-723-1980
  • Fax: 206-721-3930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0169-00
License Number StateWA
# 2
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