Provider Demographics
NPI:1821048869
Name:CYNDEE AND CMARK, LLC
Entity Type:Organization
Organization Name:CYNDEE AND CMARK, LLC
Other - Org Name:COLUMBIA TREATMENT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CLINICAL SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SIMS
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:G
Authorized Official - Suffix:
Authorized Official - Credentials:BA, CDP
Authorized Official - Phone:360-694-7484
Mailing Address - Street 1:7017 NE HIGHWAY 99
Mailing Address - Street 2:SUITE 114
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-0554
Mailing Address - Country:US
Mailing Address - Phone:360-694-7484
Mailing Address - Fax:360-694-7479
Practice Address - Street 1:7017 NE HIGHWAY 99
Practice Address - Street 2:SUITE 114
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-0554
Practice Address - Country:US
Practice Address - Phone:360-694-7484
Practice Address - Fax:360-694-7479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2009-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00001819251B00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management