Healthcare Provider Details

I. General information

NPI: 1316244999
Provider Name (Legal Business Name): ASIAN COUNSELING & REFERRAL SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2011
Last Update Date: 02/17/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3639 MARTIN LUTHER KING JR WAY S
SEATTLE WA
98144-6847
US

IV. Provider business mailing address

3639 MARTIN LUTHER KING JR WAY S
SEATTLE WA
98144-6847
US

V. Phone/Fax

Practice location:
  • Phone: 206-695-7600
  • Fax: 206-695-7606
Mailing address:
  • Phone: 206-695-7600
  • Fax: 206-695-7606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License NumberLW60050161
License Number StateWA

VIII. Authorized Official

Name: VIVIAN SUN
Title or Position: BEHAVIORAL HEALTH PROGRAM SPECIALIS
Credential:
Phone: 206-695-7560