Healthcare Provider Details

I. General information

NPI: 1154263887
Provider Name (Legal Business Name): ROBERTA J COLWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2026
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 RAINIER AVE S STE 201
SEATTLE WA
98144-4642
US

IV. Provider business mailing address

2200 RAINIER AVE S STE 201
SEATTLE WA
98144-4642
US

V. Phone/Fax

Practice location:
  • Phone: 206-417-9904
  • Fax:
Mailing address:
  • Phone: 206-417-9904
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: