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701 Dexter Ave N Ste 300 Seattle WA 98109-4342 | |
| (206) 660-3276 | |
| (866) 464-8906 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 701 Dexter Ave N Ste 300, Seattle, Washington |
| Authorized Official Name and Position | Lisa Derosier Mayfield (PRESIDENT) |
| Authorized Official Contact | 2066603276 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 31175 Seattle WA 98103-1175 Ph: (206) 660-3276 | 701 Dexter Ave N Ste 300 Seattle WA 98109-4342 Ph: (206) 660-3276 |
| NPI Number | 1699970814 |
|---|---|
| Provider Enumeration Date | 06/18/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699970814 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | LH00007998 (Washington) | Primary |
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