Healthcare Provider Details

I. General information

NPI: 1982949509
Provider Name (Legal Business Name): JOAN CLARA FISET LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2012
Last Update Date: 12/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8245 20TH AVE NE # 3
SEATTLE WA
98115-4407
US

IV. Provider business mailing address

8245 20TH AVE NE # 3
SEATTLE WA
98115-4407
US

V. Phone/Fax

Practice location:
  • Phone: 206-525-4606
  • Fax:
Mailing address:
  • Phone: 206-525-4606
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH 00004905
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: