Provider Demographics
NPI:1205685609
Name:CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
Entity type:Organization
Organization Name:CATHOLIC COMMUNITY SERVICES OF WESTERN WASHINGTON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SYSTEM OPERATIONS ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:QUINLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-940-9640
Mailing Address - Street 1:1323 YAKIMA AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4457
Mailing Address - Country:US
Mailing Address - Phone:253-502-2618
Mailing Address - Fax:
Practice Address - Street 1:319 7TH AVE SE STE 201
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1325
Practice Address - Country:US
Practice Address - Phone:253-502-2618
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-16
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health