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8709 382nd Ave Se Snoqualmie WA 98065-9623 | |
| (206) 485-0744 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 8709 382nd Ave Se, Snoqualmie, Washington |
| Authorized Official Name and Position | Megan Rose Black (OWNER & OPERATOR) |
| Authorized Official Contact | 4155250659 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
8709 382nd Ave Se Snoqualmie WA 98065-9623 Ph: (206) 485-0744 | 8709 382nd Ave Se Snoqualmie WA 98065-9623 Ph: (206) 485-0744 |
| NPI Number | 1316626948 |
|---|---|
| Provider Enumeration Date | 07/12/2023 |
| Last Update Date | 08/13/2024 |
| Certification Date | 08/13/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316626948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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