MEDICARE: DENIESSE JOAQUIN

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	101YP2500X	Professional Counselor	APCC17110	CA
2	101YP2500X	Professional Counselor	70018200	WA
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1720761109
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENIESSE JOAQUIN

Provider Business Mailing Address
First Line	:	9650 15TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98106-2576
Country	:	US
Telephone Number	:	206-965-1055
Fax Number	:	206-965-1032

Provider Business Practice Location Address
First Line	:	9650 15TH AVE SW
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98106-2576
Country	:	US
Telephone Number	:	206-965-1055
Fax Number	:	206-965-1032

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

Provider Enumeration Date	:	08/10/2023
Last Update Date	:	12/11/2025

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Directions to “ DENIESSE JOAQUIN ” Practice Location

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