MEDICARE: BEVERLY C GREENBERG MA

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	LH0003901	WA

General Provider Information

NPI Number	:	1982773305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BEVERLY C GREENBERG MA

Provider Business Mailing Address
First Line	:	1101 MADISON STREET
Second Line	:	SUITE 1260
City	:	SEATTLE
State	:	WA
Zip	:	98104-1320
Country	:	US
Telephone Number	:	206-622-5454
Fax Number	:	206-622-5501

Provider Business Practice Location Address
First Line	:	1101 MADISON STREET
Second Line	:	SUITE 1260
City	:	SEATTLE
State	:	WA
Zip	:	98104-1320
Country	:	US
Telephone Number	:	206-622-5454
Fax Number	:	206-622-5501

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	07/08/2007

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