| Market Street Psychotherapy, P S | |
|
2208 Nw Market St Ste 513 Seattle WA 98107-4098 | |
| (206) 403-1374 | |
| (206) 844-2337 |
| Full Name | Market Street Psychotherapy, P S |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 2208 Nw Market St Ste 513, Seattle, Washington |
| Authorized Official Name and Position | Jacob Jeremy Markovitz (OWNER/OPERATOR) |
| Authorized Official Contact | 2064031374 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Market Street Psychotherapy, P S 2208 Nw Market St Ste 513 Seattle WA 98107-4098 Ph: (206) 403-1374 | Market Street Psychotherapy, P S 2208 Nw Market St Ste 513 Seattle WA 98107-4098 Ph: (206) 403-1374 |
| NPI Number | 1215420963 |
|---|---|
| Provider Enumeration Date | 06/07/2018 |
| Last Update Date | 10/07/2024 |
| Certification Date | 09/16/2024 |
| Medicare PECOS PAC ID | 9830446541 |
|---|---|
| Medicare Enrollment ID | O20180725003008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215420963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | MD60484101 (Washington) | Primary |
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Secondary |
| Provider Name | Jacob J Markovitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134485147 PECOS PAC ID: 2365735123 Enrollment ID: I20160801002271 |
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