Healthcare Provider Details

I. General information

NPI: 1598334617
Provider Name (Legal Business Name): SCOTT VRANICAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2021
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4455 148TH AVE NE
BELLEVUE WA
98007-3120
US

IV. Provider business mailing address

11816 21ST AVE SW
BURIEN WA
98146-2540
US

V. Phone/Fax

Practice location:
  • Phone: 425-376-3320
  • Fax:
Mailing address:
  • Phone: 206-554-9363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLH60872275
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH60872275
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLH60872275
License Number StateWA
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60872275
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: