Healthcare Provider Details

I. General information

NPI: 1780120345
Provider Name (Legal Business Name): STEPHANIE AILEEN RAMOS LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10634 E RIVERSIDE DR STE 100
BOTHELL WA
98011-3751
US

IV. Provider business mailing address

8275 166TH AVE NE STE 200
REDMOND WA
98052-6629
US

V. Phone/Fax

Practice location:
  • Phone: 425-869-2644
  • Fax: 425-867-0930
Mailing address:
  • Phone: 425-869-2644
  • Fax: 425-867-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMG60960877
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF61233416
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: