Healthcare Provider Details

I. General information

NPI: 1790673432
Provider Name (Legal Business Name): MRF PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2025
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 NE 62ND ST
SEATTLE WA
98115-7122
US

IV. Provider business mailing address

17225 11TH AVE NE
SHORELINE WA
98155-5111
US

V. Phone/Fax

Practice location:
  • Phone: 425-243-4603
  • Fax:
Mailing address:
  • Phone: 202-445-1297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MADELEINE ROSE FERGUSON
Title or Position: THERAPIST/OWNER
Credential: LISW
Phone: 202-445-1297