Healthcare Provider Details

I. General information

NPI: 1245959543
Provider Name (Legal Business Name): CARLOS ALBERTO CUEVAS RAMIREZ MHT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8801 14TH AVE S
SEATTLE WA
98108-4809
US

IV. Provider business mailing address

PO BOX 34703
SEATTLE WA
98124-1703
US

V. Phone/Fax

Practice location:
  • Phone: 206-766-6976
  • Fax: 206-766-6993
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC61500767
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberCG61308832
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: