Provider Demographics
NPI:1063566867
Name:CHILDRENS HOME SOCIETY OF WASHINGTON
Entity type:Organization
Organization Name:CHILDRENS HOME SOCIETY OF WASHINGTON
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:MARLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORRES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-695-3200
Mailing Address - Street 1:12360 LAKE CITY WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5447
Mailing Address - Country:US
Mailing Address - Phone:206-695-3200
Mailing Address - Fax:206-695-3201
Practice Address - Street 1:4421 NE ST JOHNS RD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-2573
Practice Address - Country:US
Practice Address - Phone:360-695-1325
Practice Address - Fax:360-695-9803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health