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NPI Code Detail

MEDICARE: CASCADES WELLNESS CENTER

MEDICARE: CASCADES WELLNESS CENTER
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
1103TC1900XCounseling PsychologistPY60560787WA
2103TC0700XClinical PsychologistPY60582444WA

General Provider Information

NPI Number : 1376089151
Entity Type Code : Organization
Provider Name (Legal Business Name) : CASCADES WELLNESS CENTER
Provider Business Mailing Address
First Line : 1914 N 34TH ST STE 206
Second Line :
City : SEATTLE
State : WA
Zip : 98103-9089
Country : US
Telephone Number : 847-687-9313
Fax Number :
Provider Business Practice Location Address
First Line : 1914 N 34TH ST STE 206
Second Line :
City : SEATTLE
State : WA
Zip : 98103-9089
Country : US
Telephone Number : 847-687-9313
Fax Number :
Authorized Official
Title or Position : CLINICAL PSYCHOLOGIST
Name : DR. THOMAS FARMER
Credential : PSYD
Telephone Number : 847-687-9313
Provider Enumeration Date : 01/17/2017
Last Update Date : 10/21/2019

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Directions to “CASCADES WELLNESS CENTER ” Practice Location

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