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2719 E Madison St Ste 300 Seattle WA 98112-4752 | |
| (206) 669-4336 | |
| (206) 279-7009 |
| Full Name | |
|---|---|
| Speciality | Counselor |
| Location | 2719 E Madison St Ste 300, Seattle, Washington |
| Authorized Official Name and Position | Evonne Noble (OWNER) |
| Authorized Official Contact | 2066694336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2719 E Madison St Ste 300 Seattle WA 98112-4752 Ph: (206) 669-4336 | 2719 E Madison St Ste 300 Seattle WA 98112-4752 Ph: (206) 669-4336 |
| NPI Number | 1912310103 |
|---|---|
| Provider Enumeration Date | 06/05/2014 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/21/2024 |
| Medicare PECOS PAC ID | 6901332691 |
|---|---|
| Medicare Enrollment ID | O20241204003183 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912310103 | NPI | - | NPPES |
| Provider Name | Evonne Noble |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841604592 PECOS PAC ID: 8628504313 Enrollment ID: I20241204003535 |
| Provider Name | Alexandra R Contrades |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063066405 PECOS PAC ID: 8426584590 Enrollment ID: I20241212001736 |
| Provider Name | Molly Cvetovac |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144798653 PECOS PAC ID: 1355877457 Enrollment ID: I20241212003201 |
| Provider Name | Andrea Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225308455 PECOS PAC ID: 0244766228 Enrollment ID: I20241213002572 |
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