Healthcare Provider Details

I. General information

NPI: 1871899336
Provider Name (Legal Business Name): HIGHLINE MEDICAL CENTER CD UNIT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/01/2011
Last Update Date: 02/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12844 MILITARY RD S
TUKWILA WA
98168-3045
US

IV. Provider business mailing address

12844 MILITARY RD S
TUKWILA WA
98168-3045
US

V. Phone/Fax

Practice location:
  • Phone: 206-244-9970
  • Fax: 206-246-1426
Mailing address:
  • Phone: 206-244-9970
  • Fax: 206-246-1426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code276400000X
TaxonomySubstance Use Disorder Rehabilitation Hospital Unit
License NumberH-126
License Number StateWA

VIII. Authorized Official

Name: MICHAEL JOSEPH SHEILS
Title or Position: REVENUE CYCLE
Credential:
Phone: 206-431-5310