Basic Information
Provider Information
NPI: 1871882738
EntityType: 2
ReplacementNPI:  
OrganizationName: SKAGIT COUNTY CRISIS CENTER
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7440 W. MARGINAL WAY S.
Address2: PIONEER HUMAN SERVICES - CONTRACTS
City: SEATTLE
State: WA
PostalCode: 981084141
CountryCode: US
TelephoneNumber: 2067681990
FaxNumber: 2067688910
Practice Location
Address1: 201 LILA LN
Address2:  
City: BURLINGTON
State: WA
PostalCode: 982333320
CountryCode: US
TelephoneNumber: 3607577738
FaxNumber: 3607577749
Other Information
ProviderEnumerationDate: 03/31/2011
LastUpdateDate: 10/10/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: WOOLWORTH
AuthorizedOfficialFirstName: STEVE
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: VICE PRESIDENT, TREATMENT & REENTRY
AuthorizedOfficialTelephone: 2067667018
IsSoleProprietor:  
IsOrganizationSubpart: Y
ParentOrganizationLBN: PIONEER HUMAN SERVICES
AuthorizedOfficialNamePrefix: MR.
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000XRTF.FS.60210859WAY AgenciesCommunity/Behavioral Health 

No ID Information.


Home