MEDICARE: PAMELA RAPHAEL LMHC

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
1	101YM0800X	Mental Health Counselor	60634190	WA

General Provider Information

NPI Number	:	1386065704
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA RAPHAEL LMHC

Provider Business Mailing Address
First Line	:	PO BOX 9943
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98109-0943
Country	:	US
Telephone Number	:	425-770-4200
Fax Number	:

Provider Business Practice Location Address
First Line	:	40 LAKE BELLEVUE DR STE 100
Second Line	:
City	:	BELLEVUE
State	:	WA
Zip	:	98005-2480
Country	:	US
Telephone Number	:	425-770-4200
Fax Number	:	855-825-5420

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2014
Last Update Date	:	08/14/2025

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