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General NPI Number Information
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NPI Number | 1962549154
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Entity Type | Organization
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Legal Business Name | CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 10/15/2018
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Provider Practice Location Address
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Address Line | 1323 YAKIMA AVE
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City | TACOMA
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State | WA
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Zip | 98405-4457
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Country | US
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Telephone | 877-870-1582
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Fax | 253-272-6356
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Provider Business Mailing Address
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Address Line | 1323 YAKIMA AVE
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City | TACOMA
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State | WA
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Zip | 98405-4457
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Country | US
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Telephone | 877-870-1582
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Fax | 253-272-6356
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Authorized Official
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Title or Position | COMPLIANCE & POLICY ANALYST
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Name | STEPHANIE M. THELEN
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Credential |
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Telephone | 253-761-3898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IS-247
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License Number State | WA
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