Healthcare Provider Details

I. General information

NPI: 1326163395
Provider Name (Legal Business Name): SALVATORE BARBA PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 10/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4649 SUNNYSIDE AVE N STE 343
SEATTLE WA
98103-6955
US

IV. Provider business mailing address

6826 28TH AVE NE
SEATTLE WA
98115-7145
US

V. Phone/Fax

Practice location:
  • Phone: 206-215-0534
  • Fax: 206-524-6530
Mailing address:
  • Phone: 206-525-0750
  • Fax: 206-524-6530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberLH00003885
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00003885
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: