Provider Demographics
NPI:1801224803
Name:THE CLEARING, SPC
Entity Type:Organization
Organization Name:THE CLEARING, SPC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:H
Authorized Official - Last Name:KOELZER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MA
Authorized Official - Phone:206-303-8610
Mailing Address - Street 1:2687 W VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:FRIDAY HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98250-8164
Mailing Address - Country:US
Mailing Address - Phone:206-303-8610
Mailing Address - Fax:
Practice Address - Street 1:2687 W VALLEY RD
Practice Address - Street 2:
Practice Address - City:FRIDAY HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98250-8164
Practice Address - Country:US
Practice Address - Phone:206-303-8610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness