Healthcare Provider Details

I. General information

NPI: 1760314900
Provider Name (Legal Business Name): PORTER WOODY LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 1ST AVE STE 102
SEATTLE WA
98104-2287
US

IV. Provider business mailing address

600 1ST AVE STE 102
SEATTLE WA
98104-2287
US

V. Phone/Fax

Practice location:
  • Phone: 206-795-5073
  • Fax:
Mailing address:
  • Phone: 206-795-5073
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHCA.MC.70134503
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: