Healthcare Provider Details

I. General information

NPI: 1366871931
Provider Name (Legal Business Name): HIROMI GERETY LMHC. LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2013
Last Update Date: 12/19/2023
Certification Date: 12/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8275 166TH AVE NE STE 220
REDMOND WA
98052-6629
US

IV. Provider business mailing address

8275 166TH AVE NE STE 200
REDMOND WA
98052-6629
US

V. Phone/Fax

Practice location:
  • Phone: 425-869-2644
  • Fax: 425-867-0930
Mailing address:
  • Phone: 425-869-2644
  • Fax: 425-867-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60588790
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC007133
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number289200
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: