=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750702817
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FIONA E. O'FARRELL M.A., L.M.F.T.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/16/2013
-----------------------------------------------------
Last Update Date | 03/27/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1914 N. 34TH STREET SUITE 500
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-384-0848
-----------------------------------------------------
Fax | 206-322-2774
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1914 N. 34TH STREET SUITE 500
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-384-0848
-----------------------------------------------------
Fax | 206-322-2774
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | MFTC.0013401
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number | LF60508020
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------