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General NPI Number Information
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NPI Number | 1487448502
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Entity Type | Organization
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Legal Business Name | MINO ODE' COUNSELING PLLC
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 05/29/2025
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Provider Practice Location Address
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Address Line | 1120 PACIFIC AVE STE 100
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City | TACOMA
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State | WA
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Zip | 98402-4330
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Country | US
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Telephone | 206-414-8963
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Fax | 206-420-0332
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Provider Business Mailing Address
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Address Line | 2522 N PROCTOR ST STE 151
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City | TACOMA
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State | WA
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Zip | 98406-5338
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Country | US
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Telephone | 206-414-8963
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Fax | 206-420-0332
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Authorized Official
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Title or Position | OWNER
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Name | DEBORAH MISCHO
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Credential | LICSW
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Telephone | 206-414-8963
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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