| Organization Name: | CANYON PARK TREATMENT SOLUTIONS |
| NPI Number: | 1053328187 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAVID BENJAMIN NEWMAN (CLINIC DIRECTOR) |
| Mailing Address: | 22026 20th Ave Se Suite 101 Bothell |
| State: | WA US |
| Postal Code: | 980214449 |
| Phone Number: | 4256727293 |
| Fax Number: | |
| NPI Enumeration Date: | 08/02/2006 |
| NPI Last Update Date: | 11/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM2800X |
| License Number: | 31112100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Methadone Clinic |
| Taxonomy Definition: | An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction. |