Provider Demographics
NPI:1912520123
Name:SOUTH KING HEALTHCARE SERVICES,SPC
Entity type:Organization
Organization Name:SOUTH KING HEALTHCARE SERVICES,SPC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL CASE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RACHAEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:GATHONI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-517-8372
Mailing Address - Street 1:2505 S 320TH ST STE 235
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5461
Mailing Address - Country:US
Mailing Address - Phone:253-517-8372
Mailing Address - Fax:253-737-5772
Practice Address - Street 1:950 BROADWAY STE 434
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4445
Practice Address - Country:US
Practice Address - Phone:253-517-8372
Practice Address - Fax:253-737-5772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-21
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty