MEDICARE: MR. RICHARD EMIL DEHENES L.M.H.C.

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	LH 00006083	WA

General Provider Information

NPI Number	:	1841636040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICHARD EMIL DEHENES L.M.H.C.

Provider Business Mailing Address
First Line	:	4114 ASHWORTH AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8148
Country	:	US
Telephone Number	:	206-633-0436
Fax Number	:	206-634-4259

Provider Business Practice Location Address
First Line	:	4114 ASHWORTH AVE N
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-8148
Country	:	US
Telephone Number	:	206-633-0436
Fax Number	:	206-634-4259

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

Provider Enumeration Date	:	05/14/2013
Last Update Date	:	05/14/2013

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