Healthcare Provider Details

I. General information

NPI: 1528809944
Provider Name (Legal Business Name): DEYLIGHT CORPORATION PROFESSIONAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2024
Last Update Date: 06/03/2024
Certification Date: 06/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

753 N 35TH ST STE 208D
SEATTLE WA
98103-8870
US

IV. Provider business mailing address

7709 8TH AVE SW
SEATTLE WA
98106-2007
US

V. Phone/Fax

Practice location:
  • Phone: 206-947-7687
  • Fax:
Mailing address:
  • Phone: 206-947-7687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. EILEEN WURST
Title or Position: DIRECTOR
Credential:
Phone: 206-947-7687