Healthcare Provider Details

I. General information

NPI: 1831426741
Provider Name (Legal Business Name): ALEJANDRA MEJIA MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 12/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15811 AMBAUM BLVD SW SUITE 110
BURIEN WA
98166-3066
US

IV. Provider business mailing address

2821 SW NEVADA ST UNIT B
SEATTLE WA
98126-2597
US

V. Phone/Fax

Practice location:
  • Phone: 206-242-8211
  • Fax: 206-242-0162
Mailing address:
  • Phone: 206-409-5461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberRN60088203
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH 60517980
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: