Healthcare Provider Details

I. General information

NPI: 1932398187
Provider Name (Legal Business Name): PAMELA LERCH CAHAN MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2007
Last Update Date: 03/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 NE 155TH ST SUITE 210
SHORELINE WA
98155-7104
US

IV. Provider business mailing address

3051 NE 92ND ST
SEATTLE WA
98115-3537
US

V. Phone/Fax

Practice location:
  • Phone: 206-850-7575
  • Fax:
Mailing address:
  • Phone: 206-850-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00003740
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: