Healthcare Provider Details

I. General information

NPI: 1689754756
Provider Name (Legal Business Name): SILVERDALE PSYCHIATRIC SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9395 LINDER WAY NW SUITE # 202
SILVERDALE WA
98383-9149
US

IV. Provider business mailing address

9395 LINDER WAY NW SUITE # 202
SILVERDALE WA
98383-9149
US

V. Phone/Fax

Practice location:
  • Phone: 360-307-7010
  • Fax: 360-307-9170
Mailing address:
  • Phone: 360-307-7010
  • Fax: 360-307-9170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00003850
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number26288
License Number StateWA

VIII. Authorized Official

Name: CAROLE S. HEINE
Title or Position: OWNER/MEMBER
Credential: LMHC
Phone: 360-307-7010