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901 Boren Ave Ste 701 Seattle WA 98104-3508 | |
| (206) 409-0885 | |
| (206) 274-0021 |
| Full Name | |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 901 Boren Ave Ste 701, Seattle, Washington |
| Authorized Official Name and Position | Manivong J Ratts (CEO/PRESIDENT) |
| Authorized Official Contact | 2064090885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
4310 89th Ave Se Mercer Island WA 98040-4132 Ph: (206) 409-0885 | 901 Boren Ave Ste 701 Seattle WA 98104-3508 Ph: (206) 409-0885 |
| NPI Number | 1295276251 |
|---|---|
| Provider Enumeration Date | 03/10/2017 |
| Last Update Date | 12/18/2024 |
| Certification Date | 12/11/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295276251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (Washington) | Primary |
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