Healthcare Provider Details

I. General information

NPI: 1609739630
Provider Name (Legal Business Name): CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2025
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3205 NE 78TH ST
VANCOUVER WA
98665-0697
US

IV. Provider business mailing address

1001 N J ST
TACOMA WA
98403-2125
US

V. Phone/Fax

Practice location:
  • Phone: 253-502-2618
  • Fax:
Mailing address:
  • Phone: 206-940-9640
  • Fax: 253-830-6243

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MOLLY A QUINLAN
Title or Position: SYSTEM OPERATIONS ADMINISTRATOR
Credential: BS
Phone: 206-940-9640