Healthcare Provider Details

I. General information

NPI: 1386395986
Provider Name (Legal Business Name): TOTAL ACCESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2022
Last Update Date: 09/08/2023
Certification Date: 09/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 YESLER WAY APT 407
SEATTLE WA
98104-3724
US

IV. Provider business mailing address

725 HERTEL AVE UNIT 383
BUFFALO NY
14207-7015
US

V. Phone/Fax

Practice location:
  • Phone: 206-487-8245
  • Fax:
Mailing address:
  • Phone: 206-407-4250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health 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

VIII. Authorized Official

Name: MELIA SMITH
Title or Position: COO
Credential:
Phone: 206-407-4250