Healthcare Provider Details

I. General information

NPI: 1376324210
Provider Name (Legal Business Name): ELIZABETH JEAN HA LMHC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH JEAN HA ATR-P

II. Dates (important events)

Enumeration Date: 10/06/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17825 59TH AVE NE STE B
ARLINGTON WA
98223-6453
US

IV. Provider business mailing address

2821 MISSION HILL RD
TULALIP WA
98271-9706
US

V. Phone/Fax

Practice location:
  • Phone: 360-363-4234
  • Fax: 363-363-4235
Mailing address:
  • Phone: 360-716-4400
  • Fax: 425-259-8626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.61609422
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: