Provider Demographics
NPI:1619020302
Name:RECOVERY CENTERS OF KING COUNTY
Entity Type:Organization
Organization Name:RECOVERY CENTERS OF KING COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:A/P-BILLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:MARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSNESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-568-8226
Mailing Address - Street 1:464 12TH AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5567
Mailing Address - Country:US
Mailing Address - Phone:206-322-2970
Mailing Address - Fax:206-568-8253
Practice Address - Street 1:505 WASHINGTON AVE S
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5709
Practice Address - Country:US
Practice Address - Phone:253-854-6513
Practice Address - Fax:253-854-6521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1014574Medicaid
WA1014574Medicaid