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General NPI Number Information
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NPI Number | 1407261019
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Entity Type | Individual
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Provider Name | TSION KIDANE LMFTA
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Gender | Female
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 11320 ROOSEVELT WAY NE
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City | SEATTLE
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State | WA
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Zip | 98125-6228
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Country | US
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Telephone | 206-234-6249
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Fax |
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Provider Business Mailing Address
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Address Line | 1116 NW 54TH ST APT # 203
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City | SEATTLE
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State | WA
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Zip | 98107-3750
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Country | US
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Telephone | 206-234-6249
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MG 60408946
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License Number State | WA
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