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General NPI Number Information
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NPI Number | 1376905539
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Entity Type | Organization
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Legal Business Name | ARLENROSE FRAZIER
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Dates
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Enumeration Date | 03/25/2016
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 15879 15TH AVE NE
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City | SHORELINE
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State | WA
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Zip | 98155-6335
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Country | US
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Telephone | 206-226-6020
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 55757
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City | SHORELINE
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State | WA
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Zip | 98155-0757
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Country | US
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Telephone | 206-226-6020
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ARLENROSE FRAZIER
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Credential | M.A.
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Telephone | 206-226-6020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | LH00004908
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License Number State | WA
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