Healthcare Provider Details

I. General information

NPI: 1013795012
Provider Name (Legal Business Name): DEBORA SILVA DE SOUZA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2023
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3016 4TH AVE W
SEATTLE WA
98119-1905
US

IV. Provider business mailing address

3016 4TH AVE W
SEATTLE WA
98119-1905
US

V. Phone/Fax

Practice location:
  • Phone: 360-504-6232
  • Fax:
Mailing address:
  • Phone: 206-206-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: