Healthcare Provider Details

I. General information

NPI: 1316118177
Provider Name (Legal Business Name): UNITED NW RECOVERY CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 SUNSET PARK DR STE B
SEDRO WOOLLEY WA
98284-1589
US

IV. Provider business mailing address

605 SUNSET PARK DR STE B
SEDRO WOOLLEY WA
98284-1589
US

V. Phone/Fax

Practice location:
  • Phone: 360-856-6300
  • Fax: 360-854-9062
Mailing address:
  • Phone: 360-856-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number StateWA

VIII. Authorized Official

Name: MS. BARBARA JEAN THOMPSON
Title or Position: DIRECTOR
Credential: CDP
Phone: 360-856-6300