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General NPI Number Information
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NPI Number | 1851431282
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Entity Type | Organization
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Legal Business Name | NORTHWEST FAMILY LIFE LEARNING AND COUNSELING CENTER
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 05/21/2018
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Provider Practice Location Address
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Address Line | 12360 LAKE CITY WAY NE SUITE 420
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City | SEATTLE
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State | WA
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Zip | 98125
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Country | US
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Telephone | 206-363-9601
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Fax | 206-363-9639
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Provider Business Mailing Address
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Address Line | 12360 LAKE CITY WAY NE SUITE 420
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City | SEATTLE
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State | WA
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Zip | 98125
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Country | US
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Telephone | 206-363-9601
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Fax | 206-363-9639
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | HAN-MAE ELLA CHANG
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Credential | LMHC
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Telephone | 206-363-9601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 601196797
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License Number State | WA
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