Healthcare Provider Details

I. General information

NPI: 1134875073
Provider Name (Legal Business Name): MS. ANASTASIA WEBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1909 214TH ST SE STE 204
BOTHELL WA
98021-4415
US

IV. Provider business mailing address

2402 NW 195TH PL
SHORELINE WA
98177-2932
US

V. Phone/Fax

Practice location:
  • Phone: 425-219-4788
  • Fax: 425-219-4790
Mailing address:
  • Phone: 206-364-3777
  • Fax: 206-364-3999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSWI.LW.70035839
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: