Provider Demographics
NPI:1013942978
Name:CHIILDRENS HOME SOCIETY OF WASHINGTON
Entity Type:Organization
Organization Name:CHIILDRENS HOME SOCIETY OF WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:D
Authorized Official - Middle Name:SHARON
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-695-3200
Mailing Address - Street 1:PO BOX 15190
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-0190
Mailing Address - Country:US
Mailing Address - Phone:206-695-3200
Mailing Address - Fax:206-695-3201
Practice Address - Street 1:1612 PENNY LANE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4474
Practice Address - Country:US
Practice Address - Phone:509-529-2130
Practice Address - Fax:509-526-3640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2008-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA103261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health