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NPI Code Detail

MEDICARE: ELIZABETH A. HEATH M.A.

MEDICARE: ELIZABETH A. HEATH M.A.
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 CounselorLH 00008637WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1LH 00008637OTHERWAMENTAL HEALTH COUNSELOR LICENSE

General Provider Information

NPI Number : 1275778250
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH A. HEATH M.A.
Provider Business Mailing Address
First Line : 4219 SW JUNEAU ST
Second Line :
City : SEATTLE
State : WA
Zip : 98136-1621
Country : US
Telephone Number : 206-326-9111
Fax Number :
Provider Business Practice Location Address
First Line : 4219 SW JUNEAU ST
Second Line :
City : SEATTLE
State : WA
Zip : 98136-1621
Country : US
Telephone Number : 206-326-9111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2008
Last Update Date : 12/04/2008

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