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General NPI Number Information
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NPI Number | 1841835725
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Entity Type | Individual
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Provider Name | STEPHANIE BATES LMFT, SUDPT
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Gender | Female
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Dates
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Enumeration Date | 11/14/2019
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 4649 SUNNYSIDE AVE N STE 347
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City | SEATTLE
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State | WA
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Zip | 98103-6963
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Country | US
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Telephone | 425-583-9925
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 791
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City | EDMONDS
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State | WA
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Zip | 98020-0791
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Country | US
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Telephone |
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF61194456
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License Number State | WA
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