Healthcare Provider Details

I. General information

NPI: 1073492823
Provider Name (Legal Business Name): ARIANA GAMMON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 E MADISON ST STE 306
SEATTLE WA
98112-4865
US

IV. Provider business mailing address

2800 E MADISON ST STE 306
SEATTLE WA
98112-4865
US

V. Phone/Fax

Practice location:
  • Phone: 844-701-1080
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSYA.PG.70123247
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: