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General NPI Number Information
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NPI Number | 1093122269
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Entity Type | Organization
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Legal Business Name | PIB-PROCESO
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Dates
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Enumeration Date | 07/18/2014
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Last Update Date | 07/18/2014
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Provider Practice Location Address
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Address Line | 1833 N 105TH ST STE 101
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City | SEATTLE
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State | WA
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Zip | 98133-8973
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Country | US
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Telephone | 206-478-1191
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Fax | 206-260-3060
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Provider Business Mailing Address
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Address Line | 1833 N 105TH ST STE 101
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City | SEATTLE
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State | WA
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Zip | 98133-8973
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Country | US
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Telephone | 206-478-1191
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Fax | 206-260-3060
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Authorized Official
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Title or Position | DIRECTOR/PARTNER
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Name | MARCO SANCHEZ
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Credential | MA, MHP, CDP, DVC
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Telephone | 206-478-1191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 17156500
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License Number State | WA
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