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316 Main St Suite A2 Edmonds WA 98020-3197 | |
(425) 870-6500 | |
Not Available |
Full Name | |
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Speciality | Counselor - Mental Health |
Location | 316 Main St, Edmonds, Washington |
Authorized Official Name and Position | Teri Jean Johnson (LICENSED MENTAL HEALTH COUNSELOR) |
Authorized Official Contact | 4258706500 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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316 Main St Suite A2 Edmonds WA 98020-3197 Ph: (425) 870-6500 | 316 Main St Suite A2 Edmonds WA 98020-3197 Ph: (425) 870-6500 |
NPI Number | 1750826509 |
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Provider Enumeration Date | 01/04/2017 |
Last Update Date | 01/04/2017 |
Identifier | Type | State | Issuer |
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1750826509 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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101YM0800X | Counselor - Mental Health | LH60448422 (Washington) | Primary |
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