Healthcare Provider Details

I. General information

NPI: 1245188150
Provider Name (Legal Business Name): ELIZABETH MITCHELL MHCA.MC.70092511
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 160TH ST S STE 101
SPANAWAY WA
98387-8508
US

IV. Provider business mailing address

4913 180TH ST SW APT 7
LYNNWOOD WA
98037-3613
US

V. Phone/Fax

Practice location:
  • Phone: 253-881-9854
  • Fax: 253-409-2622
Mailing address:
  • Phone: 425-977-9220
  • Fax: 425-818-2696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMHCS.MC.70092511
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: