Healthcare Provider Details

I. General information

NPI: 1003567637
Provider Name (Legal Business Name): WASHINGTON YA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2022
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16227 RAILROAD WAY
SNOHOMISH WA
98296-8173
US

IV. Provider business mailing address

L-4046
COLUMBUS OH
43260-4046
US

V. Phone/Fax

Practice location:
  • Phone: 714-202-5166
  • Fax: 866-273-8095
Mailing address:
  • Phone: 714-202-5166
  • Fax: 866-273-8095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: KEITH THOMPSON
Title or Position: CHIEF LEGAL AND DEVELOPMENT OFFICER
Credential:
Phone: 949-432-4622