Provider Demographics
NPI:1922780527
Name:SOUND LIFE RECOVERY, PLLC
Entity Type:Organization
Organization Name:SOUND LIFE RECOVERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:KILGOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-340-9288
Mailing Address - Street 1:1200 HARRIS AVE STE 410
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7148
Mailing Address - Country:US
Mailing Address - Phone:360-340-9288
Mailing Address - Fax:
Practice Address - Street 1:1200 HARRIS AVE STE 410
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-7148
Practice Address - Country:US
Practice Address - Phone:360-340-9288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health