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General NPI Number Information
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NPI Number | 1417236639
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Entity Type | Organization
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Legal Business Name | SCIENCE AND MANAGEMENT OF ADDICTIONS
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 08/04/2011
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Provider Practice Location Address
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Address Line | 18 W MERCER ST SUITE 370
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City | SEATTLE
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State | WA
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Zip | 98119-3965
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Country | US
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Telephone | 206-328-1719
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Fax | 206-547-1727
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Provider Business Mailing Address
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Address Line | 18 W MERCER ST SUITE 370
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City | SEATTLE
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State | WA
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Zip | 98119-3965
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Country | US
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Telephone | 206-328-1719
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Fax | 206-547-1727
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | GINA GRAPPONE
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Credential |
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Telephone | 206-328-1719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 17151000
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License Number State | WA
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