Healthcare Provider Details

I. General information

NPI: 1497258479
Provider Name (Legal Business Name): ASHLEY MCQUOWN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2018
Last Update Date: 03/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2732 GRAND AVE
EVERETT WA
98201-3416
US

IV. Provider business mailing address

2732 GRAND AVE
EVERETT WA
98201-3416
US

V. Phone/Fax

Practice location:
  • Phone: 425-259-5842
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCO60485547
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: