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NPI Code Detail

MEDICARE: MARA B MEZA

MEDICARE:   MARA B MEZA
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
1101Y00000XCounselorCG60686934WA
2101YM0800XMental Health CounselorMC61396666WA

General Provider Information

NPI Number : 1760933600
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARA B MEZA
Provider Business Mailing Address
First Line : 19143 15TH AVE NW
Second Line :
City : SHORELINE
State : WA
Zip : 98177-2723
Country : US
Telephone Number : 253-397-7650
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 : 206-207-5395
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2016
Last Update Date : 01/27/2023

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Directions to “ MARA B MEZA ” Practice Location

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