Provider Demographics
NPI:1730571803
Name:CENTER FOR INDEPENDENCE
Entity type:Organization
Organization Name:CENTER FOR INDEPENDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:KOSIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-582-1253
Mailing Address - Street 1:7801 BRIDGEPORT WAY W
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8440
Mailing Address - Country:US
Mailing Address - Phone:253-582-1253
Mailing Address - Fax:253-584-4374
Practice Address - Street 1:7801 BRIDGEPORT WAY W
Practice Address - Street 2:SUITE 200
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8440
Practice Address - Country:US
Practice Address - Phone:253-582-1253
Practice Address - Fax:253-584-4374
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA601439153251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management