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NPI Code Detail

MEDICARE: IAN MEARNS EDD, MSW, MA, LICSWA

MEDICARE: IAN MEARNS EDD, MSW, MA, LICSWA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1093234577
Entity Type Code : Individual
Provider Name (Legal Business Name) : IAN MEARNS EDD, MSW, MA, LICSWA
Provider Business Mailing Address
First Line : 119 23RD AVE
Second Line :
City : SEATTLE
State : WA
Zip : 98122-6018
Country : US
Telephone Number : 206-503-3628
Fax Number :
Provider Business Practice Location Address
First Line : 4501 15TH AVE S STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98108-1874
Country : US
Telephone Number : 425-491-6650
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2017
Last Update Date : 04/08/2026

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Directions to “ IAN MEARNS EDD, MSW, MA, LICSWA” Practice Location

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