Healthcare Provider Details

I. General information

NPI: 1104420678
Provider Name (Legal Business Name): DOMINIQUE SAVAGE B.A, M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2020
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N 34TH ST STE 320
SEATTLE WA
98103-5296
US

IV. Provider business mailing address

400 N 34TH ST STE 320
SEATTLE WA
98103-5296
US

V. Phone/Fax

Practice location:
  • Phone: 206-486-8270
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: