MEDICARE: DELEONA M GARRISON

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1881949741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DELEONA M GARRISON

Provider Business Mailing Address
First Line	:	16715 AURORA AVE N STE 102
Second Line	:
City	:	SHORELINE
State	:	WA
Zip	:	98133-5310
Country	:	US
Telephone Number	:	206-546-9766
Fax Number	:

Provider Business Practice Location Address
First Line	:	16715 AURORA AVE N STE 102
Second Line	:
City	:	SHORELINE
State	:	WA
Zip	:	98133-5310
Country	:	US
Telephone Number	:	206-546-9766
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2012
Last Update Date	:	07/17/2012

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Directions to “ DELEONA M GARRISON ” Practice Location

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