Healthcare Provider Details

I. General information

NPI: 1669140216
Provider Name (Legal Business Name): BRIANNA MARIE WALSH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6990 EAST GREEN LAKE WAY N SUITE G
SEATTLE WA
98115
US

IV. Provider business mailing address

1208 10TH AVE W APT C4
SEATTLE WA
98119-3402
US

V. Phone/Fax

Practice location:
  • Phone: 360-515-4865
  • Fax:
Mailing address:
  • Phone: 201-563-6683
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61665925
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLH61665925
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number23-297
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: