Healthcare Provider Details

I. General information

NPI: 1669701603
Provider Name (Legal Business Name): AMBER HOUSOUER CMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2009
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date: 08/11/2015
Reactivation Date: 05/26/2026

III. Provider practice location address

2820 21ST ST
EVERETT WA
98201-2521
US

IV. Provider business mailing address

2820 21ST ST
EVERETT WA
98201-2521
US

V. Phone/Fax

Practice location:
  • Phone: 831-421-1683
  • Fax:
Mailing address:
  • Phone: 831-421-1683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70082895
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: