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General NPI Number Information
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NPI Number | 1548894405
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Entity Type | Individual
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Provider Name | JESS GOODENOW MASON LMHC
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Gender |
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Dates
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Enumeration Date | 02/28/2020
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 753 N 35TH STREET, SUITE 310 FREMONT PROFESSIONAL CENTER
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City | SEATTLE
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State | WA
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Zip | 98103-8873
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Country | US
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Telephone | 425-539-0525
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Fax | 425-553-3988
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Provider Business Mailing Address
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Address Line | 753 N 35TH ST STE 310
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City | SEATTLE
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State | WA
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Zip | 98103-8873
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Country | US
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Telephone | 425-539-0525
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Fax | 425-553-3988
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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 | LH61014420
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License Number State | WA
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