Provider Demographics
NPI:1417236639
Name:SCIENCE AND MANAGEMENT OF ADDICTIONS
Entity Type:Organization
Organization Name:SCIENCE AND MANAGEMENT OF ADDICTIONS
Other - Org Name:SAMA FOUNDATION
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAPPONE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-328-1719
Mailing Address - Street 1:18 W MERCER ST
Mailing Address - Street 2:SUITE 370
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-3965
Mailing Address - Country:US
Mailing Address - Phone:206-328-1719
Mailing Address - Fax:206-547-1727
Practice Address - Street 1:18 W MERCER ST
Practice Address - Street 2:SUITE 370
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-3965
Practice Address - Country:US
Practice Address - Phone:206-328-1719
Practice Address - Fax:206-547-1727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA17151000101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA17151000OtherCHEMICAL DEPENDENCY AGENCY