| Full Name | |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 904 7th Ave, Seattle, Washington |
| Authorized Official Name and Position | George Go (BOARD PRESIDENT) |
| Authorized Official Contact | 4252590966 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 5127 Everett WA 98206-5127 Ph: (142) 530-4843 | 904 7th Ave Seattle WA 98104-1132 Ph: (425) 339-5453 |
| NPI Number | 1386380533 |
|---|---|
| Provider Enumeration Date | 05/10/2022 |
| Last Update Date | 04/09/2024 |
| Certification Date | 04/09/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386380533 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
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