Healthcare Provider Details
I. General information
NPI: 1720028988
Provider Name (Legal Business Name): MEIER CLINICS OF CALIFORNIA INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/07/2006
Last Update Date: 12/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
22232 17TH AVE SE SUITE 312
BOTHELL WA
98021-7430
US
IV. Provider business mailing address
22232 17TH AVE SE SUITE 312
BOTHELL WA
98021-7430
US
V. Phone/Fax
- Phone: 630-653-1717
- Fax: 630-653-7926
- Phone: 630-653-1717
- Fax: 630-653-7926
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | RC00044759 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | RC00044760 |
| License Number State | WA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | LH00005033 |
| License Number State | WA |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY00001807 |
| License Number State | WA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY00001469 |
| License Number State | WA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY00003289 |
| License Number State | WA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY00002604 |
| License Number State | WA |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY00003255 |
| License Number State | WA |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | LW00006435 |
| License Number State | WA |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY00002496 |
| License Number State | WA |
VIII. Authorized Official
Name:
SANDY
NEWPORT
Title or Position: NAT. EX. ASST.
Credential:
Phone: 630-653-1717
