Healthcare Provider Details

I. General information

NPI: 1619020310
Provider Name (Legal Business Name): SEATTLE CHILDREN'S HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2142 10TH AVE W
SEATTLE WA
98119-2845
US

IV. Provider business mailing address

2142 10TH AVE W
SEATTLE WA
98119-2845
US

V. Phone/Fax

Practice location:
  • Phone: 206-283-3300
  • Fax:
Mailing address:
  • Phone: 206-283-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License NumberRTF-1057
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number041
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number018
License Number StateWA

VIII. Authorized Official

Name: GENA M PALM
Title or Position: EXECUTIVE DIRECTOR
Credential: ED.D., LCSW (NY)
Phone: 206-283-3300