| Organization Name: | EASTSIDE THERAPEUTIC RESOURCE |
| NPI Number: | 1033231410 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SHAUNA KNUTSON (COORDINATOR) |
| Mailing Address: | 830 6th St S Kirkland |
| State: | WA US |
| Postal Code: | 980336714 |
| Phone Number: | 4254439551 |
| Fax Number: | 4258280691 |
| NPI Enumeration Date: | 04/04/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1744R1102X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | Research Study |
| Taxonomy Definition: | |