Healthcare Provider Details

I. General information

NPI: 1144367350
Provider Name (Legal Business Name): FRIENDS OF YOUTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

414 FRONT ST N
ISSAQUAH WA
98027-2914
US

IV. Provider business mailing address

16225 NE 87TH ST STE A-6
REDMOND WA
98052-3536
US

V. Phone/Fax

Practice location:
  • Phone: 425-392-6367
  • Fax: 425-391-4971
Mailing address:
  • Phone: 425-869-6490
  • Fax: 425-869-6666

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number153
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number17040901
License Number StateWA

VIII. Authorized Official

Name: PAULA L FREDERICK
Title or Position: DIRECTOR OF YOUTH & FAMILY SERVICES
Credential:
Phone: 425-392-6367