MEDICARE: MR. JORGE TOVAR JR. 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	LH60920602	WA
2	101YM0800X	Mental Health Counselor	MC60407020	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LH60920602	OTHER	WA	DEPT OF HEALTH - WA

General Provider Information

NPI Number	:	1831618057
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JORGE TOVAR JR. LMHC

Provider Business Mailing Address
First Line	:	600 N 36TH ST STE 426
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8827
Country	:	US
Telephone Number	:	425-354-4038
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 N 36TH ST STE 327
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8699
Country	:	US
Telephone Number	:	425-354-4038
Fax Number	:

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

Provider Enumeration Date	:	09/19/2017
Last Update Date	:	07/21/2022

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