Healthcare Provider Details

I. General information

NPI: 1487194569
Provider Name (Legal Business Name): REACH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2017
Last Update Date: 03/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2133 3RD AVE
SEATTLE WA
98121-2385
US

IV. Provider business mailing address

2133 3RD AVE
SEATTLE WA
98121-2385
US

V. Phone/Fax

Practice location:
  • Phone: 206-432-3574
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateWA

VIII. Authorized Official

Name: MARGARET CARNEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 206-223-3644