Provider Demographics
NPI:1013109966
Name:EASTSIDE ADDICTION PROFESSIONALS
Entity type:Organization
Organization Name:EASTSIDE ADDICTION PROFESSIONALS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALFORD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:206-604-0939
Mailing Address - Street 1:1940 116TH AVE NE STE 103
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3011
Mailing Address - Country:US
Mailing Address - Phone:425-462-8558
Mailing Address - Fax:425-462-8556
Practice Address - Street 1:1940 116TH AVE NE STE 103
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3011
Practice Address - Country:US
Practice Address - Phone:425-462-8558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty