| Ebb And Flow Mental Health | |
|
18208 66th Ave Ne Ste 201 Kenmore WA 98028-7949 | |
| (425) 814-2045 | |
| (425) 814-2783 |
| Full Name | Ebb And Flow Mental Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 18208 66th Ave Ne Ste 201, Kenmore, Washington |
| Authorized Official Name and Position | Mercedes Marie Alice (OWNER) |
| Authorized Official Contact | 4256156696 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ebb And Flow Mental Health 13022 66th Ave Se Snohomish WA 98296-8997 Ph: (425) 615-6696 | Ebb And Flow Mental Health 18208 66th Ave Ne Ste 201 Kenmore WA 98028-7949 Ph: (425) 814-2045 |
| NPI Number | 1114571643 |
|---|---|
| Provider Enumeration Date | 08/01/2019 |
| Last Update Date | 07/31/2024 |
| Certification Date | 07/31/2024 |
| Medicare PECOS PAC ID | 3476882309 |
|---|---|
| Medicare Enrollment ID | O20190903000198 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114571643 | NPI | - | NPPES |
| 2085918 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mercedes M Alice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033475348 PECOS PAC ID: 3375772379 Enrollment ID: I20140218000563 |
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