Provider Demographics
NPI:1528045721
Name:SOUND CHOICE HEALTH CENTER, P.S.
Entity Type:Organization
Organization Name:SOUND CHOICE HEALTH CENTER, P.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LEA
Authorized Official - Last Name:KABACY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-456-0291
Mailing Address - Street 1:PO BOX 8880
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98509-8880
Mailing Address - Country:US
Mailing Address - Phone:360-456-0291
Mailing Address - Fax:360-456-0559
Practice Address - Street 1:8617 MARTIN WAY E
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98516-5805
Practice Address - Country:US
Practice Address - Phone:360-456-0291
Practice Address - Fax:360-456-0559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8114688Medicaid