Healthcare Provider Details

I. General information

NPI: 1518258144
Provider Name (Legal Business Name): JOSEF C. AFANADOR ED. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/30/2011
Last Update Date: 04/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BROADWAY STE 315
SEATTLE WA
98122-4304
US

IV. Provider business mailing address

1001 BROADWAY STE 315
SEATTLE WA
98122-4304
US

V. Phone/Fax

Practice location:
  • Phone: 206-419-0333
  • Fax: 206-323-3687
Mailing address:
  • Phone: 206-419-0333
  • Fax: 206-323-3687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00005923
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: