MEDICARE: MS. JILLIAN RILEY MUSCATEL MA, 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	101Y00000X	Counselor	CG60407877	WA
2	101YM0800X	Mental Health Counselor	CG60407877	WA
3	101YM0800X	Mental Health Counselor	LH60956297	WA

General Provider Information

NPI Number	:	1972939320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JILLIAN RILEY MUSCATEL MA, LMHC

Provider Business Mailing Address
First Line	:	2711 E MADISON ST STE 210
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-4763
Country	:	US
Telephone Number	:	206-472-1699
Fax Number	:

Provider Business Practice Location Address
First Line	:	2711 E MADISON ST STE 210
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98112-4763
Country	:	US
Telephone Number	:	206-472-1699
Fax Number	:

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

Provider Enumeration Date	:	09/17/2013
Last Update Date	:	09/19/2023

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