Healthcare Provider Details

I. General information

NPI: 1962081398
Provider Name (Legal Business Name): CONSEJO CONSELING AND REFERRAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2021
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E COLLEGE WAY
MOUNT VERNON WA
98273-5612
US

IV. Provider business mailing address

723 SW 10TH ST
RENTON WA
98057-5223
US

V. Phone/Fax

Practice location:
  • Phone: 206-461-4880
  • Fax: 206-461-6989
Mailing address:
  • Phone: 206-461-4880
  • Fax: 206-461-6989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHANA BOSCHMA
Title or Position: IS DIRECTOR
Credential:
Phone: 206-461-4880