Healthcare Provider Details

I. General information

NPI: 1285807032
Provider Name (Legal Business Name): GABRIELLE HOPE-FOUCAULT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2008
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4555 DELRIDGE WAY SW
SEATTLE WA
98106-1379
US

IV. Provider business mailing address

4555 DELRIDGE WAY SW
SEATTLE WA
98106-1379
US

V. Phone/Fax

Practice location:
  • Phone: 206-937-7680
  • Fax: 206-935-9967
Mailing address:
  • Phone: 206-937-7680
  • Fax: 206-935-9967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00009901
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: