Healthcare Provider Details

I. General information

NPI: 1083294938
Provider Name (Legal Business Name): DOROTHY Z GREENE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 AURORA AVE N STE 211
SEATTLE WA
98103-7853
US

IV. Provider business mailing address

3426 NW 57TH ST
SEATTLE WA
98107-3349
US

V. Phone/Fax

Practice location:
  • Phone: 206-391-6992
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF.61610859
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: