Provider Demographics
NPI:1780313320
Name:XCHANGE BEHAVIORAL HEALTH AGENCY
Entity type:Organization
Organization Name:XCHANGE BEHAVIORAL HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAMI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MCKINZEY-BARTELMIE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, SUDP
Authorized Official - Phone:360-989-4890
Mailing Address - Street 1:PO BOX 1299
Mailing Address - Street 2:
Mailing Address - City:BATTLE GROUND
Mailing Address - State:WA
Mailing Address - Zip Code:98604-1299
Mailing Address - Country:US
Mailing Address - Phone:844-777-9242
Mailing Address - Fax:
Practice Address - Street 1:21810 NE 37TH AVE
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:WA
Practice Address - Zip Code:98642-7747
Practice Address - Country:US
Practice Address - Phone:844-777-9242
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-08
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management