| Autismwave Therapy Services | |
|
13312 Se 262nd St Kent WA 98042-8521 | |
| (206) 582-9392 | |
| Not Available |
| Full Name | Autismwave Therapy Services |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 13312 Se 262nd St, Kent, Washington |
| Authorized Official Name and Position | Samuel Bullock (COO) |
| Authorized Official Contact | 5623575705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Autismwave Therapy Services 13312 Se 262nd St Kent WA 98042-8521 Ph: (206) 582-9392 | Autismwave Therapy Services 13312 Se 262nd St Kent WA 98042-8521 Ph: (206) 582-9392 |
| NPI Number | 1376219691 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 08/17/2021 |
| Certification Date | 08/17/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376219691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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