THE JUANITA CENTER LLC (NPI# 1467908855) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467908855 |
| Entity Type | Organization |
| Organization Name | THE JUANITA CENTER LLC |
| Practice Address |
627 5th St Suite 100a Mukilteo WA 98275-1580 |
| Practice Telephone | 4253289528 |
| Practice Fax Number | 4257869276 |
| Mailing Telephone | 4253289528 |
| Mailing Fax Number | 4257869276 |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-27 |
| Authorized Official Name | MR. GARY R MCCULLOUGH (DIRECTOR) |
| Authorized Official Telephone | 4253289528 |
| Authorized Official Credential | CDP, SAP, NCAC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
31-1480-00 | WA | Ambulatory Health Care Facilities |
| Street Address |
627 5TH ST SUITE 100A |
| City | MUKILTEO |
| State | WA |
| Zip Code | 98275-1580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568570612 | Mary L Peters | Counselor | 627 5th St, Suite 201, Mukilteo, WA 98275-1580 | 2006-08-28 |
| 1548550197 | Lawrence Rodney Amburgy | Specialist | 627 5th St, Suite 200, Mukilteo, WA 98275-1580 | 2011-04-17 |
| 1972801454 | Geraldine Helwing | Counselor | 627 5th St, Ste 201, Mukilteo, WA 98275-1580 | 2011-03-07 |
| 1720256555 | Gary R Mccullough | Counselor | 627 5th St, Suite 100a, Mukilteo, WA 98275-1580 | 2008-02-14 |
| 1942418173 | Anne Louise Katherine | Counselor | 627 5th St, Suite 202, Mukilteo, WA 98275-1580 | 2007-05-20 |
| 1497892095 | Lynette A Gardiner | Counselor | 627 5th St, Suite 201, Mukilteo, WA 98275-1580 | 2007-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477030245 | Brandon Eugene Moore | Social Worker | 12303 Cyrus Way, Suite 107, Mukilteo, WA 98275 | 2018-07-25 |
| 1407349962 | Cascade Endocrinology Pllc | Internal Medicine | 8423 Mukilteo Spdwy Ste 102, Mukilteo, WA 98275 | 2018-06-10 |
| 1780059899 | Jamie Kowatch | Dietitian, Registered | 8423 Mukilteo Speedway Ste 102, Mukilteo, WA 98275 | 2015-12-01 |
| 1225479025 | Helen Ra | Pharmacist | 5600 Harbour Pointe Blvd., Unit 1-105, Mukilteo, WA 98275 | 2013-07-10 |
| 1861731333 | Lynn Sharon Schmidt | Physical Therapist | 10520 Harbour Pointe Blvd, Columbia Elementary School - Msd #6, Mukilteo, WA 98275 | 2013-02-04 |
| 1023318326 | Hillary E Hofstaedter | Registered Nurse | 10710 Mukilteo Speedway # 67, Mukilteo, WA 98275 | 2010-11-02 |
| 1528371416 | Zita Molnar Fekete | Counselor | 4460 73rd Pl Sw, Mukilteo, WA 98275 | 2010-07-20 |
| 1497900609 | Heidi S. Rendall | Family Medicine | 8227 44th Ave W., Ste E, Mukilteo, WA 98275 | 2008-12-02 |
| 1558583609 | Ana B Rountree | Physician Assistant | 10710 Mukilteo Spdwy, Mukilteo, WA 98275 | 2007-05-02 |
| 1376769752 | Wahid Elbahr | Dentist | 12121 Harbour Reach Dr., Ste 210, Mukilteo, WA 98275 | 2007-04-17 |
| Find all providers in zip 98275 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
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| 1437634730 | Hazelden Betty Ford Foundation | Clinic/Center | 1231 116th Ave. Ne Suite 410, Bellevue, WA 98004 | 2018-10-02 |
| 1780174441 | American Behavioral Health Systems, Inc. | Clinic/Center | 715 E Sprague Ave Ste 107, Spokane, WA 99202-2142 | 2018-05-17 |
| 1598255267 | American Behavioral Healt Systems, Inc. | Clinic/Center | 7208 267th St Nw Ste A-100, Stanwood, WA 98292-6289 | 2018-05-17 |
| 1437648136 | American Behavioral Health Systems, Inc. | Clinic/Center | 8625 Evergreen Way Ste 100, Everett, WA 98208-2620 | 2018-05-08 |
| 1487143350 | Steve Parker | Clinic/Center | 1206 State Ave Ste H, Marysville, WA 98270-3645 | 2018-05-07 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.