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General NPI Number Information
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NPI Number | 1255987368
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Entity Type | Organization
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Legal Business Name | PACIFIC MENTAL HEALTH LLC
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 03/12/2025
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Provider Practice Location Address
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Address Line | 5108 196TH ST SW STE 350
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City | LYNNWOOD
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State | WA
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Zip | 98036-6169
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Country | US
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Telephone | 425-582-2041
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Fax |
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Provider Business Mailing Address
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Address Line | 5108 196TH ST SW C/O RXDX MEDICAL BILLING SERVICES LLC, STE 310
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City | LYNNWOOD
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State | WA
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Zip | 98036-6169
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Country | US
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Telephone | 425-697-3674
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Fax | 888-641-6642
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Authorized Official
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Title or Position | BILLING SPECIALIST
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Name | JEANETTE ELIASSEN
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Credential |
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Telephone | 425-697-3674
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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