Healthcare Provider Details

I. General information

NPI: 1003623950
Provider Name (Legal Business Name): SIENNA MENDEZ
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2024
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5608 17TH AVE NW STE 1668
SEATTLE WA
98107-5232
US

IV. Provider business mailing address

5608 17TH AVE NW STE 1668
SEATTLE WA
98107-5232
US

V. Phone/Fax

Practice location:
  • Phone: 206-672-3202
  • Fax:
Mailing address:
  • Phone: 206-672-3202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.700878937
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: