MEDICARE: THERAPEUTIC HEALTH SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM2800X	Methadone Clinic

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053400077
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC HEALTH SERVICES

Provider Business Mailing Address
First Line	:	5802 RAINIER AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-2706
Country	:	US
Telephone Number	:	206-723-1980
Fax Number	:

Provider Business Practice Location Address
First Line	:	1305 SENECA ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98101-2828
Country	:	US
Telephone Number	:	206-323-0930
Fax Number	:	206-323-0933

Authorized Official
Title or Position	:	BILLING MANAGER
Name	:	SEAN POTTER
Credential	:
Telephone Number	:	206-323-0930

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	10/04/2023

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Directions to “THERAPEUTIC HEALTH SERVICES ” Practice Location

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