=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477009199
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COLLEEN HILTON, LMFT, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/01/2016
-----------------------------------------------------
Last Update Date | 09/01/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 40 LAKE BELLEVUE DR 100
-----------------------------------------------------
City | BELLEVUE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98005-2480
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-280-1395
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 19819 30TH DR SE
-----------------------------------------------------
City | BOTHELL
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98012-7260
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 425-280-1395
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MS. COLLEEN HILTON
-----------------------------------------------------
Credential | MA, LMFT
-----------------------------------------------------
Telephone | 425-280-1395
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251S00000X
-----------------------------------------------------
Taxonomy Name | Community/Behavioral Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------