Healthcare Provider Details

I. General information

NPI: 1053248542
Provider Name (Legal Business Name): DAVID RADOMSKI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2008 WESTLAKE AVE STE 100
SEATTLE WA
98121-2695
US

IV. Provider business mailing address

4019 S 150TH ST
TUKWILA WA
98188-2222
US

V. Phone/Fax

Practice location:
  • Phone: 206-860-4199
  • Fax:
Mailing address:
  • Phone: 206-729-2733
  • 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: