Healthcare Provider Details

I. General information

NPI: 1164972600
Provider Name (Legal Business Name): SENSUM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2016
Last Update Date: 10/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 WESTLAKE AVE N SUITE 901
SEATTLE WA
98109-3543
US

IV. Provider business mailing address

1244 20TH AVE E
SEATTLE WA
98112-3531
US

V. Phone/Fax

Practice location:
  • Phone: 206-354-1754
  • Fax:
Mailing address:
  • Phone: 206-354-1754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberLH00009300
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License NumberLH00009300
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberLH00009300
License Number StateWA

VIII. Authorized Official

Name: MS. TIFFANY J DORRELL DAHL
Title or Position: LISENCED MENTAL HEALTH COUNSELOR
Credential: M.A., LMHC
Phone: 206-354-1754