Provider Demographics
NPI:1336438407
Name:PATHWAYS FOR RECOVERY
Entity type:Organization
Organization Name:PATHWAYS FOR RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:LOVELESS
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,NCACII,CDP
Authorized Official - Phone:360-516-6592
Mailing Address - Street 1:3100 NW BUCKLIN HILL RD
Mailing Address - Street 2:STE 246
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8358
Mailing Address - Country:US
Mailing Address - Phone:360-516-6592
Mailing Address - Fax:360-516-6594
Practice Address - Street 1:3100 NW BUCKLIN HILL RD
Practice Address - Street 2:STE 246
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8358
Practice Address - Country:US
Practice Address - Phone:360-516-6592
Practice Address - Fax:360-516-6594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-29
Last Update Date:2014-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00004660251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health