Healthcare Provider Details

I. General information

NPI: 1639089345
Provider Name (Legal Business Name): ANSLEY ROBERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17018 15TH AVE NE
SHORELINE WA
98155-5137
US

IV. Provider business mailing address

8414 NE 148TH PL
KENMORE WA
98028-4726
US

V. Phone/Fax

Practice location:
  • Phone: 646-469-8792
  • Fax:
Mailing address:
  • Phone: 206-362-7282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: