Provider Demographics
NPI:1891008173
Name:THERAPEUTIC HEALTH SERVICES
Entity Type:Organization
Organization Name:THERAPEUTIC HEALTH SERVICES
Other - Org Name:CENTER FOR CLINICAL EXCELLENCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SALOSHNI
Authorized Official - Middle Name:
Authorized Official - Last Name:KEELING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-323-0930
Mailing Address - Street 1:1116 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2831
Mailing Address - Country:US
Mailing Address - Phone:206-323-0930
Mailing Address - Fax:206-454-3778
Practice Address - Street 1:1901 MARTIN LUTHER KING JR WAY S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-4801
Practice Address - Country:US
Practice Address - Phone:206-322-7676
Practice Address - Fax:206-726-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA032251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1018901Medicaid