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General NPI Number Information
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NPI Number | 1396258364
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR FAMILY DEVELOPMENT
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Dates
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Enumeration Date | 11/13/2017
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Last Update Date | 11/13/2017
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Provider Practice Location Address
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Address Line | 204 QUINCE ST. NE, SUITE 200
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City | OLYMPIA
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State | WA
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Zip | 98506
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Country | US
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Telephone | 360-459-4281
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Fax | 360-459-1790
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Provider Business Mailing Address
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Address Line | 34004 16TH AVENUE SOUTH, SUITE 200
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City | FEDERAL WAY
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State | WA
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Zip | 98003
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Country | US
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Telephone | 253-874-3630
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Fax | 253-838-1670
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. CHARLOTTE BOOTH
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Credential |
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Telephone | 253-874-3630
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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 | LH00010370
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License Number State | WA
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