NPI Code Details Logo

NPI 1255213310

NPI 1255213310 : CAROLINE CIESKO : ISSAQUAH, WA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1255213310
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    CAROLINE CIESKO
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    07/21/2025
-----------------------------------------------------
    Last Update Date     |    08/05/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1420 NW GILMAN BLVD STE 2 
-----------------------------------------------------
    City                 |    ISSAQUAH
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    98027-5333
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    425-243-4209
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1420 NW GILMAN BLVD STE 2 PMB9194
-----------------------------------------------------
    City                 |    ISSAQUAH
-----------------------------------------------------
    State                |    WA
-----------------------------------------------------
    Zip                  |    98027-5333
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    425-243-4209
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    101YM0800X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Counselor
-----------------------------------------------------
    License Number       |    MC61666662
-----------------------------------------------------
    License Number State |    WA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.