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NPI Code Detail

MEDICARE: LAURA HAVIVA MOSS

MEDICARE: LAURA HAVIVA MOSS
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 CounselorMHC.LH.60947015WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MHC.LH.60947015OTHERWAWASHINGTON STATE DEPARTMENT OF HEALTH

General Provider Information

NPI Number : 1336793082
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA HAVIVA MOSS
Provider Business Mailing Address
First Line : 3715 S HUDSON ST STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98118-2171
Country : US
Telephone Number : 206-890-7227
Fax Number :
Provider Business Practice Location Address
First Line : 3715 S HUDSON ST STE 102
Second Line :
City : SEATTLE
State : WA
Zip : 98118-2171
Country : US
Telephone Number : 626-999-0835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2019
Last Update Date : 01/22/2026

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Directions to “ LAURA HAVIVA MOSS ” Practice Location

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