MEDICARE: ARTFUL HEALING LLC

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
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1588434120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTFUL HEALING LLC

Provider Business Mailing Address
First Line	:	PMB 6832 PO BOX 257
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98507
Country	:	US
Telephone Number	:	425-276-1459
Fax Number	:

Provider Business Practice Location Address
First Line	:	4864 RAINIER AVE S
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98118-1742
Country	:	US
Telephone Number	:	425-276-1459
Fax Number	:

Authorized Official
Title or Position	:	LICENSED MENTAL HEALTH COUNSELOR
Name	:	JESS ANNA DALE
Credential	:	LMHC, ATR.
Telephone Number	:	425-276-1459

Provider Enumeration Date	:	01/04/2024
Last Update Date	:	01/29/2024

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