| Peaceful Heart Therapy, Pllc | |
|
205 S 51st St # 9e Renton WA 98055-7942 | |
| (425) 525-9792 | |
| Not Available |
| Full Name | Peaceful Heart Therapy, Pllc |
|---|---|
| Speciality | Counselor |
| Location | 205 S 51st St # 9e, Renton, Washington |
| Authorized Official Name and Position | Seolah Park (SOLE OWNER) |
| Authorized Official Contact | 4255259792 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peaceful Heart Therapy, Pllc 205 S 51st St # 9e Renton WA 98055-7942 Ph: (425) 525-9792 | Peaceful Heart Therapy, Pllc 205 S 51st St # 9e Renton WA 98055-7942 Ph: (425) 525-9792 |
| NPI Number | 1497521694 |
|---|---|
| Provider Enumeration Date | 11/29/2023 |
| Last Update Date | 11/29/2023 |
| Certification Date | 11/28/2023 |
| Medicare PECOS PAC ID | 9537507256 |
|---|---|
| Medicare Enrollment ID | O20240401001591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497521694 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Seolah Park |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093270704 PECOS PAC ID: 0446698161 Enrollment ID: I20240401001827 |
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