Provider Demographics
NPI:1215673470
Name:YVONNE MARISA DOELLING PLLC
Entity type:Organization
Organization Name:YVONNE MARISA DOELLING PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSLEOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:MARISA
Authorized Official - Last Name:DOELLING
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC, MHP, ATR-P
Authorized Official - Phone:206-305-0080
Mailing Address - Street 1:705 S WELLER ST APT 201
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-3076
Mailing Address - Country:US
Mailing Address - Phone:206-305-0080
Mailing Address - Fax:
Practice Address - Street 1:506 2ND AVE STE 1400
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2329
Practice Address - Country:US
Practice Address - Phone:206-305-0080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA604756841OtherUNIFIED BUSINESS ID