Healthcare Provider Details

I. General information

NPI: 1043666175
Provider Name (Legal Business Name): GRETCHEN GERHARDT LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2016
Last Update Date: 08/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3272 CALIFORNIA AVE SW STE 300
SEATTLE WA
98116
US

IV. Provider business mailing address

3935 SW ELMGROVE ST
SEATTLE WA
98136-2326
US

V. Phone/Fax

Practice location:
  • Phone: 415-841-2471
  • Fax:
Mailing address:
  • Phone: 206-930-9596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC60679190
License Number StateWA
# 2
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: