Healthcare Provider Details

I. General information

NPI: 1851780340
Provider Name (Legal Business Name): YVONNE MARISA DOELLING MA, MHP, LMHCA, ATRP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/21/2015
Last Update Date: 04/27/2021
Certification Date: 04/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 S WELLER ST APT 201
SEATTLE WA
98104-3076
US

IV. Provider business mailing address

705 S WELLER ST APT 201
SEATTLE WA
98104-3076
US

V. Phone/Fax

Practice location:
  • Phone: 206-430-0169
  • Fax:
Mailing address:
  • Phone: 206-430-0169
  • Fax: 206-430-0169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC60683335
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: