1881942035 NPI number — TOUCHSTONE BEHAVIORAL HEALTH, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881942035 NPI number — TOUCHSTONE BEHAVIORAL HEALTH, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOUCHSTONE BEHAVIORAL HEALTH, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881942035
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/02/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
288 MARTIN ST. BOX 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BLAINE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98230
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-788-4228
Provider Business Mailing Address Fax Number:
360-778-1423

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
288 MARTIN ST.
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
BLAINE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-788-4228
Provider Business Practice Location Address Fax Number:
360-778-1423
Provider Enumeration Date:
08/20/2012

Additional Information

Authorized Official

Authorized Official Last Name:
CREYDT
Authorized Official First Name:
ERIKA
Authorized Official Middle Name:
KRISTINA GERVOL
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
360-990-3848

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com