| Queen Anne Relationship Therapy | |
|
1811 Queen Anne Ave N 204 Seattle WA 98109-2850 | |
| (206) 283-3374 | |
| Not Available |
| Full Name | Queen Anne Relationship Therapy |
|---|---|
| Speciality | Social Worker |
| Location | 1811 Queen Anne Ave N, Seattle, Washington |
| Authorized Official Name and Position | Laurie Ruth Moss (PSYCHOTHERAPIST/PARTNER) |
| Authorized Official Contact | 2062833374 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Queen Anne Relationship Therapy 1811 Queen Anne Ave N 204 Seattle WA 98109-2850 Ph: (206) 283-3374 | Queen Anne Relationship Therapy 1811 Queen Anne Ave N 204 Seattle WA 98109-2850 Ph: (206) 283-3374 |
| NPI Number | 1871985721 |
|---|---|
| Provider Enumeration Date | 03/02/2015 |
| Last Update Date | 03/02/2015 |
| Medicare PECOS PAC ID | 8224346440 |
|---|---|
| Medicare Enrollment ID | O20151007001758 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871985721 | NPI | - | NPPES |
| 1952596512 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LW00004305 (Washington) | Primary |
| Provider Name | Gregory L Ostergaard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952596512 PECOS PAC ID: 4587972708 Enrollment ID: I20151007003119 |
| Provider Name | Laurie Ruth Moss |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457546087 PECOS PAC ID: 7113235334 Enrollment ID: I20240524002591 |
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