Healthcare Provider Details

I. General information

NPI: 1215673470
Provider Name (Legal Business Name): YVONNE MARISA DOELLING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 06/23/2022
Certification Date: 06/23/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 2ND AVE STE 1400
SEATTLE WA
98104-2329
US

IV. Provider business mailing address

705 S WELLER ST APT 201
SEATTLE WA
98104-3076
US

V. Phone/Fax

Practice location:
  • Phone: 206-305-0080
  • Fax:
Mailing address:
  • Phone: 206-305-0080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. YVONNE MARISA DOELLING
Title or Position: OWNER/COUNSLEOR
Credential: MA, LMHC, MHP, ATR-P
Phone: 206-305-0080