Provider Demographics
NPI:1134114283
Name:SHERWOOD COMMUNITY SERVICES
Entity type:Organization
Organization Name:SHERWOOD COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-404-3107
Mailing Address - Street 1:402 91ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-2530
Mailing Address - Country:US
Mailing Address - Phone:425-334-4071
Mailing Address - Fax:425-335-1894
Practice Address - Street 1:402 91ST AVE NE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-2530
Practice Address - Country:US
Practice Address - Phone:425-334-4071
Practice Address - Fax:425-335-1894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-14
Last Update Date:2021-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8373243Medicaid
WA8373276Medicaid
WA8374621Medicaid
WA8373268Medicaid
WA8373318Medicaid
WA8373284Medicaid