| Basics Nw, Llc | |
|
50 Se Blue Heron Ln Shelton WA 98584-7658 | |
| (360) 280-4414 | |
| (360) 547-6470 |
| Full Name | Basics Nw, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 50 Se Blue Heron Ln, Shelton, Washington |
| Authorized Official Name and Position | Matthew Jeffrey Woodard (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3602804414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Basics Nw, Llc 50 Se Blue Heron Ln Shelton WA 98584-7658 Ph: (360) 280-4414 | Basics Nw, Llc 50 Se Blue Heron Ln Shelton WA 98584-7658 Ph: (360) 280-4414 |
| NPI Number | 1073864849 |
|---|---|
| Provider Enumeration Date | 09/20/2012 |
| Last Update Date | 09/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073864849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | CL60302030 (Washington) | Primary |
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