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General NPI Number Information
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NPI Number | 1962825489
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Entity Type | Individual
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Provider Name | SIGNAL DIYMOKE MITCHELL
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Gender | Female
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 1700 AIRPORT WAY S
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City | SEATTLE
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State | WA
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Zip | 98134-1618
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Country | US
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Telephone | 206-223-3644
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Fax | 206-223-1482
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Provider Business Mailing Address
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Address Line | 10828 GRAVELLY LAKE DR SW STE 106
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City | LAKEWOOD
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State | WA
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Zip | 98499-1300
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Country | US
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Telephone | 253-651-1841
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Fax | 253-267-5831
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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