Healthcare Provider Details

I. General information

NPI: 1003939034
Provider Name (Legal Business Name): PIONEER HUMAN SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/06/2007
Last Update Date: 01/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 FAWCETT AVE STE 200
TACOMA WA
98402-2024
US

IV. Provider business mailing address

7440 W. MARGINAL WAY S. PIONEER HUMAN SERVICES - CONTRACTS
SEATTLE WA
98108-4141
US

V. Phone/Fax

Practice location:
  • Phone: 253-274-0484
  • Fax: 253-274-1457
Mailing address:
  • Phone: 206-768-1990
  • Fax: 206-768-8910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number27114000
License Number StateWA

VIII. Authorized Official

Name: MR. STEVE WOOLWORTH
Title or Position: VICE PRESIDENT, TREATMENT & REENTRY
Credential:
Phone: 206-766-7018