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NPI Code Detail

MEDICARE: RECOVERY CENTERS OF KING COUNTY

MEDICARE: RECOVERY CENTERS OF KING COUNTY
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
1261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center

Other Identifiers

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

General Provider Information

NPI Number : 1619020302
Entity Type Code : Organization
Provider Name (Legal Business Name) : RECOVERY CENTERS OF KING COUNTY
Provider Business Mailing Address
First Line : 464 12TH AVE
Second Line : SUITE 300
City : SEATTLE
State : WA
Zip : 98122-5567
Country : US
Telephone Number : 206-322-2970
Fax Number : 206-568-8253
Provider Business Practice Location Address
First Line : 505 WASHINGTON AVE S
Second Line :
City : KENT
State : WA
Zip : 98032-5709
Country : US
Telephone Number : 253-854-6513
Fax Number : 253-854-6521
Authorized Official
Title or Position : A/P-BILLING SPECIALIST
Name : MARILYN RUSNESS
Credential :
Telephone Number : 206-568-8226
Provider Enumeration Date : 01/18/2007
Last Update Date : 04/26/2011

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Directions to “RECOVERY CENTERS OF KING COUNTY ” Practice Location

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