Healthcare Provider Details

I. General information

NPI: 1043018443
Provider Name (Legal Business Name): ECHO GLEN CHILDRENS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33010 SE 99TH ST
SNOQUALMIE WA
98065-9797
US

IV. Provider business mailing address

33010 SE 99TH ST
SNOQUALMIE WA
98065-9797
US

V. Phone/Fax

Practice location:
  • Phone: 425-831-2500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. SETH A BAFFOE
Title or Position: HEALTH SERVICES ADMINISTRATOR
Credential:
Phone: 360-628-3192