CHS NORTHSHORE 103RD
NPI 1598103624
Clinic/Center - Rehabilitation, Substance Use Disorder in Bothell, WA

NPI Status: Active since June 11, 2013

Contact Information

18414 103RD AVE NE
BOTHELL, WA
ZIP 98011
Phone: (206) 362-7282
Fax: (206) 362-7152

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  • Organization
  • Clinic/Center
  • Rehabilitation, Substance Use Disorder

About CHS NORTHSHORE 103RD

This page provides the complete NPI Profile along with additional information for Chs Northshore 103rd, a provider established in Bothell, Washington operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1598103624 assigned on June 2013. The practitioner's primary taxonomy code is 261QR0405X with license number 17153800 (WA). The provider is registered as an organization and their NPI record was last updated 12 years ago. The provider's other name is Chs Northshore 103rd. The authorized official of this NPI record is Beratta Gomillion (Executive Director)

NPI
1598103624
Provider Legal Name
CENTER FOR HUMAN SERVICES
Other Organization Name
CHS NORTHSHORE 103RD
Other Name Type
Other Name (5)
Entity Type
Organization
Location Address
18414 103RD AVE NE BOTHELL, WA 98011
Location Phone
(206) 362-7282
Location Fax
(206) 362-7152
Mailing Address
17018 15TH AVE NE SHORELINE, WA 98155
Mailing Phone
(206) 362-7282
Mailing Fax
(206) 362-7152
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
06-11-2013
Last Update Date
06-14-2013
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Clinic/Center Rehabilitation, Substance Use Disorder

Taxonomy Code
261QR0405X
Type
Ambulatory Health Care Facilities
License No.
17153800
License State
WA

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1251B00000XAgencies

Case Management

17153800 (WA)

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

BERATTA GOMILLION

Authorized Official Title
EXECUTIVE DIRECTOR
Authorized Official Phone
(206) 362-7282

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1598103624
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2518820664
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 5 + 1 + 8 + 8 + 2 + 0 + 6 + 6 + 4 + 24 = 66
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 66 = 44

The NPI number 1598103624 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1598103624, enumerated as an "organization" on June 11, 2013.

The provider is located at 18414 103RD AVE NE BOTHELL, WA 98011 and the phone number is (206) 362-7282.

Clinic/Center with taxonomy code 261QR0405X and a focus in Rehabilitation, Substance Use Disorder.