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NPI Code Detail

MEDICARE: DANIELLE LAUREN GONZALES LMFT

MEDICARE: DANIELLE LAUREN GONZALES LMFT
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
1106H00000XMarriage & Family TherapistMG60883467WA
2106H00000XMarriage & Family TherapistLF61567663WA

General Provider Information

NPI Number : 1770114605
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE LAUREN GONZALES LMFT
Provider Business Mailing Address
First Line : 6553 CALIFORNIA AVE SW STE B
Second Line :
City : SEATTLE
State : WA
Zip : 98136-1896
Country : US
Telephone Number : 206-395-4373
Fax Number :
Provider Business Practice Location Address
First Line : 6553 CALIFORNIA AVE SW STE B
Second Line :
City : SEATTLE
State : WA
Zip : 98136-1896
Country : US
Telephone Number : 206-395-4373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2020
Last Update Date : 11/07/2024

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