Healthcare Provider Details

I. General information

NPI: 1356913362
Provider Name (Legal Business Name): LORENA JEANINE RAMIREZ FLORES LIC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2021
Last Update Date: 07/11/2021
Certification Date: 07/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8615 14TH AVE S
SEATTLE WA
98108-4806
US

IV. Provider business mailing address

8615 14TH AVE S
SEATTLE WA
98108-4806
US

V. Phone/Fax

Practice location:
  • Phone: 206-762-0489
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: