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37909 Hood Canal Dr Ne Hansville WA 98340-8786 | |
| (801) 663-3811 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 37909 Hood Canal Dr Ne, Hansville, Washington |
| Authorized Official Name and Position | David James Daroff (COUNSELOR) |
| Authorized Official Contact | 8016633811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
37909 Hood Canal Dr Ne Hansville WA 98340-8786 Ph: (801) 663-3811 | 37909 Hood Canal Dr Ne Hansville WA 98340-8786 Ph: (801) 663-3811 |
| NPI Number | 1669248092 |
|---|---|
| Provider Enumeration Date | 11/27/2023 |
| Last Update Date | 05/14/2024 |
| Certification Date | 05/14/2024 |
| Medicare PECOS PAC ID | 6406298728 |
|---|---|
| Medicare Enrollment ID | O20240531000880 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669248092 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM0855X | Clinic/center - Adolescent And Children Mental Health | (* (Not Available)) | Secondary |
| Provider Name | David J Daroff |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649868266 PECOS PAC ID: 7214379536 Enrollment ID: I20240531000930 |