Provider Demographics
NPI:1699948570
Name:DRUG EVALUATION, TREATMENT & OUTPATIENT SERVICES LLC
Entity type:Organization
Organization Name:DRUG EVALUATION, TREATMENT & OUTPATIENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:L
Authorized Official - Last Name:PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-802-2861
Mailing Address - Street 1:10634 E RIVERSIDE DR STE 130
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3758
Mailing Address - Country:US
Mailing Address - Phone:425-806-5021
Mailing Address - Fax:
Practice Address - Street 1:10634 E RIVERSIDE DR STE 130
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3758
Practice Address - Country:US
Practice Address - Phone:425-806-5021
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA426OtherDETOCS