Healthcare Provider Details

I. General information

NPI: 1558420620
Provider Name (Legal Business Name): PERINATAL TREATMENT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4810 S WILKESON ST
TACOMA WA
98408-1419
US

IV. Provider business mailing address

4810 S WILKESON ST
TACOMA WA
98408-1419
US

V. Phone/Fax

Practice location:
  • Phone: 253-475-2500
  • Fax: 253-471-2884
Mailing address:
  • Phone: 253-475-2500
  • Fax: 253-471-2884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License NumberPE153
License Number StateWA

VIII. Authorized Official

Name: KAY E SEIM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 206-223-1300