NPIMap

Organization Active NPI

West Sound Treatment Center (Poulsbo)

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Poulsbo, WA
National Provider Identifier
1366837650
Registry record updated Apr 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
600554448 Issued in WA
Legal business name
WEST SOUND TREATMENT CENTER (POULSBO)
Practice address
19351 8TH Ave NE
Suite # 204
Poulsbo, WA 98370-8710
Phone
(360) 876-9430
Fax
(360) 876-0713
NPI assigned
Apr 2, 2015
Organization subpart
Yes
Parent organization
WEST SOUND TREATMENT CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 2, 2015

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

Authorized official

Name
Robin B O'Grady, CDP
Title
Executive Director
Phone
(360) 876-9430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 600554448 WA Primary

Addresses

Primary practice location

19351 8TH Ave NE
Suite # 204
Poulsbo, WA 98370-8710

Mailing address

19351 8TH Ave NE
Suite # 204
Poulsbo, WA 98370-8710
Phone (360) 876-9430

Other identifiers 1

IdentifierTypeStateIssuer
18169700MedicaidWA

National Provider Directory

National Provider Directory
Tax ID family
West Sound Treatment Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

19351 8th Ave NE
Ste 204
Poulsbo, WA 98370
Phone (360) 876-9430

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1427932800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1366837650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19351 8TH AVE NE",
            "address_2": "SUITE # 204",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708710",
            "telephone_number": "360-876-9430",
            "fax_number": "360-876-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19351 8TH AVE NE",
            "address_2": "SUITE # 204",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983708710",
            "telephone_number": "360-876-9430",
            "fax_number": "360-876-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SOUND TREATMENT CENTER (POULSBO)",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WEST SOUND TREATMENT CENTER",
        "enumeration_date": "2015-04-02",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "O'GRADY",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "360-876-9430",
        "authorized_official_credential": "CDP"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "WA",
            "license": "600554448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "18169700",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.