Healthcare Provider Details

I. General information

NPI: 1215495387
Provider Name (Legal Business Name): MATTHEW ADAM SCHWARTZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2019
Last Update Date: 03/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 S WALKER ST
SEATTLE WA
98144-4710
US

IV. Provider business mailing address

2600 S WALKER ST
SEATTLE WA
98144-4710
US

V. Phone/Fax

Practice location:
  • Phone: 206-224-3746
  • Fax: 206-436-8388
Mailing address:
  • Phone: 206-224-3746
  • Fax: 206-436-8388

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: