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General NPI Number Information
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NPI Number | 1326561663
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Entity Type | Organization
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Legal Business Name | COMMUNITY PSYCHIATRIC CLINIC INC
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Dates
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Enumeration Date | 07/19/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11000 LAKE CITY WAY NE STE 200
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City | SEATTLE
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State | WA
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Zip | 98125-6748
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Country | US
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Telephone | 206-747-7191
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Fax |
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Provider Business Mailing Address
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Address Line | 11000 LAKE CITY WAY NE STE 200
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City | SEATTLE
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State | WA
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Zip | 98125-6748
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Country | US
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Telephone | 206-747-7191
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Fax |
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Authorized Official
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Title or Position | ADMIN SERVICES MANAGER
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Name | KELCEY SYMONS
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Credential |
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Telephone | 206-545-2387
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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