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General NPI Number Information
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NPI Number | 1770007387
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Entity Type | Organization
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Legal Business Name | MORINA COUNSELING, PC
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 08/04/2017
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Provider Practice Location Address
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Address Line | 9415 ROOSEVELT WAY NE
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City | SEATTLE
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State | WA
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Zip | 98115-2843
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Country | US
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Telephone | 360-623-3126
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Fax | 360-623-3126
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Provider Business Mailing Address
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Address Line | 718 4TH AVE N APT 44
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City | SEATTLE
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State | WA
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Zip | 98109-4236
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Country | US
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Telephone | 360-623-3126
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PHILLIP THOMAS MORINA
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Credential | MS , LMFT
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Telephone | 360-623-3126
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 60483234
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License Number State | WA
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