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NPI Code Detail

MEDICARE: ANTONY WOLF NARCISO

MEDICARE: ANTONY WOLF NARCISO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor
2103K00000XBehavior AnalystCG60677601WA
3390200000XStudent in an Organized Health Care Education/Training Program
4101YM0800XMental Health CounselorLH61516265WA

General Provider Information

NPI Number : 1417308479
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTONY WOLF NARCISO
Provider Business Mailing Address
First Line : 580 8TH AVE NE UNIT 207
Second Line :
City : ISSAQUAH
State : WA
Zip : 98029-5902
Country : US
Telephone Number : 425-213-3020
Fax Number :
Provider Business Practice Location Address
First Line : 195 NE GILMAN BLVD STE 100
Second Line :
City : ISSAQUAH
State : WA
Zip : 98027-2940
Country : US
Telephone Number : 425-295-7697
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2016
Last Update Date : 02/19/2024

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Directions to “ ANTONY WOLF NARCISO ” Practice Location

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