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22232 17th Ave Se Ste 305 Bothell WA 98021-7425 | |
| (801) 655-5450 | |
| (385) 225-9327 |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 22232 17th Ave Se Ste 305, Bothell, Washington |
| Authorized Official Name and Position | Jen Carter (OWNER) |
| Authorized Official Contact | 8016098093 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
1469 N 1200 W Orem UT 84057-2449 Ph: (801) 655-5450 | 22232 17th Ave Se Ste 305 Bothell WA 98021-7425 Ph: (801) 655-5450 |
| NPI Number | 1467230284 |
|---|---|
| Provider Enumeration Date | 09/21/2023 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Medicare PECOS PAC ID | 8022558717 |
|---|---|
| Medicare Enrollment ID | O20240909002857 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467230284 | NPI | - | NPPES |
| Provider Name | Rachel Carley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932942216 PECOS PAC ID: 2668912247 Enrollment ID: I20240910002029 |
| Provider Name | Whitney Lynne Hutchings |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598366148 PECOS PAC ID: 3870033046 Enrollment ID: I20240913003488 |
| Provider Name | Dylan Wallace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982269155 PECOS PAC ID: 3173060076 Enrollment ID: I20240918001759 |
| Provider Name | Rebecca Ann Wierman |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114506938 PECOS PAC ID: 8123475092 Enrollment ID: I20241107003079 |
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