Healthcare Provider Details

I. General information

NPI: 1942775200
Provider Name (Legal Business Name): ANTONIO JOSE ZUNIGA LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/12/2018
Last Update Date: 09/26/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4407C 42ND AVE SW
SEATTLE WA
98116-4222
US

IV. Provider business mailing address

4407C 42ND AVE SW
SEATTLE WA
98116-4222
US

V. Phone/Fax

Practice location:
  • Phone: 206-446-9996
  • Fax:
Mailing address:
  • Phone: 206-446-9996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61543290
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: