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12360 Lake City Way Ne Suite 420 Seattle WA 98125 | |
| (206) 363-9601 | |
| (206) 363-9639 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12360 Lake City Way Ne, Seattle, Washington |
| Authorized Official Name and Position | Han-mae Ella Chang (CLINICAL DIRECTOR) |
| Authorized Official Contact | 2063639601 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12360 Lake City Way Ne Suite 420 Seattle WA 98125 Ph: (206) 363-9601 | 12360 Lake City Way Ne Suite 420 Seattle WA 98125 Ph: (206) 363-9601 |
| NPI Number | 1851431282 |
|---|---|
| Provider Enumeration Date | 02/07/2007 |
| Last Update Date | 05/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851431282 | NPI | - | NPPES |
| 307827 | Other | WA | VALUEOPTIONS PROVIDER # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 601196797 (Washington) | Primary |
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