Healthcare Provider Details

I. General information

NPI: 1770231763
Provider Name (Legal Business Name): CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2022
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10604 NE HIGHWAY 99
VANCOUVER WA
98686-5613
US

IV. Provider business mailing address

10604 NE HIGHWAY 99
VANCOUVER WA
98686-5613
US

V. Phone/Fax

Practice location:
  • Phone: 360-690-6638
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 QUINLAN
Title or Position: OPERATIONS ADMINISTRATOR
Credential:
Phone: 206-940-9640