Healthcare Provider Details

I. General information

NPI: 1518682798
Provider Name (Legal Business Name): LAURA MIOLA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 04/30/2025
Certification Date: 04/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23842 SE 41ST ST
SAMMAMISH WA
98029-6311
US

IV. Provider business mailing address

23842 SE 41ST ST
SAMMAMISH WA
98029-6311
US

V. Phone/Fax

Practice location:
  • Phone: 425-295-8610
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61668774
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: