NPIMap

Organization Active NPI

Therapeutic Health Services

Doing business as Shoreline Branch

  • Methadone Clinic
  • Shoreline, WA
National Provider Identifier
1144312877
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Methadone ClinicTaxonomy code 261QM2800X
Legal business name
THERAPEUTIC HEALTH SERVICES
Doing business as
Shoreline Branch
Practice address
16715 Aurora Ave N Ste 102
Shoreline, WA 98133-5310
Phone
(206) 323-0930
Fax
(206) 454-3778
NPI assigned
Sep 29, 2006
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Sean Potter
Title
Billing Manager
Phone
(206) 323-0930

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Methadone Clinic 261QM2800X NU Primary

Addresses

Primary practice location

16715 Aurora Ave N Ste 102
Shoreline, WA 98133-5310

Mailing address

5802 Rainier Ave S
Seattle, WA 98118-2706
Phone (206) 723-1980

Other identifiers 1

IdentifierTypeStateIssuer
1991116MedicaidWA

Other names 1

  • Shoreline Branch Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA2 enrollments
Opioid treatment program
Medicare-enrolled since Mar 27, 2023

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120206000766 WA Part B Supplier - Clinic/Group Practice 4284891052 Receives reassigned benefits from 20 practitioners
8 other NPIs on this enrollment
Practice locations: Shoreline, WA; Seattle, WA; Kent, WA; Everett, WA; Bellevue, WA
O20200924001786 WA Part B Supplier - Opioid Treatment Program (Otp) 4284891052 8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bellevue, WA; Everett, WA; Seattle, WA; Shoreline, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2165974Therupeutic Health Services - Shoreline Branch16715 Aurora Ave N #102, Shoreline, WA 98133Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Therapeutic Health Serv13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1412 140th Pl NE
Bellevue, WA 98007
Phone (425) 747-7892

1116 Summit Ave
Seattle, WA 98101
Phone (206) 323-0930

Practitioners & affiliated clinicians

Practitioners 108

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 108

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1144312877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 RAINIER AVE S",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981182706",
            "telephone_number": "206-723-1980",
            "fax_number": "206-721-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16715 AURORA AVE N STE 102",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981335310",
            "telephone_number": "206-323-0930",
            "fax_number": "206-454-3778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPEUTIC HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "SEAN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "206-323-0930"
    },
    "taxonomies": [
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1991116",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shoreline Branch",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Shoreline Branch",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.