Provider Demographics
NPI:1407574239
Name:CHAPLAINS ON THE HARBOR
Entity Type:Organization
Organization Name:CHAPLAINS ON THE HARBOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:D
Authorized Official - Last Name:OLIVE
Authorized Official - Suffix:
Authorized Official - Credentials:CPC
Authorized Official - Phone:360-523-5293
Mailing Address - Street 1:52 ARLAND RD
Mailing Address - Street 2:
Mailing Address - City:MONTESANO
Mailing Address - State:WA
Mailing Address - Zip Code:98563-9624
Mailing Address - Country:US
Mailing Address - Phone:360-637-9962
Mailing Address - Fax:
Practice Address - Street 1:52 ARLAND RD
Practice Address - Street 2:
Practice Address - City:MONTESANO
Practice Address - State:WA
Practice Address - Zip Code:98563-9624
Practice Address - Country:US
Practice Address - Phone:360-637-9962
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management