Healthcare Provider Details

I. General information

NPI: 1467067439
Provider Name (Legal Business Name): NEW ADVANCED HEALTHCARE CONSULTING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/15/2020
Last Update Date: 09/15/2020
Certification Date: 09/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LENORA ST # 984
SEATTLE WA
98121-2411
US

IV. Provider business mailing address

608 APPLEJACK CT
ANTIOCH TN
37013-4893
US

V. Phone/Fax

Practice location:
  • Phone: 206-606-3231
  • Fax: 206-441-9122
Mailing address:
  • Phone: 206-606-3231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: NONYEREM ROSEMARY ENEJE
Title or Position: DIRECTOR
Credential: DNP, PMHNP-BC, FNP
Phone: 206-606-3231