Provider Demographics
NPI:1487026076
Name:CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
Entity Type:Organization
Organization Name:CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
Other - Org Name:FBH TUKWILA
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:QUINLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-940-9640
Mailing Address - Street 1:631 STRANDER BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-2963
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6840 FORT DENT WAY STE 350
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-8512
Practice Address - Country:US
Practice Address - Phone:253-850-2500
Practice Address - Fax:253-850-2530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-22
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)