Basic Information
| Provider Information | |||||||||
| NPI: | 1740460534 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOJANG | ||||||||
| FirstName: | ANNETTE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | RC, NA, AAC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | DELA CRUZ | ||||||||
| OtherFirstName: | ANNETTE | ||||||||
| OtherMiddleName: | SENATO | ||||||||
| OtherNamePrefix: | MISS | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1600 E OLIVE ST | ||||||||
| Address2: | SOUND MENTAL HEALTH | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981222735 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2063022200 | ||||||||
| FaxNumber: | 2063022210 | ||||||||
| Practice Location | |||||||||
| Address1: | 11629 AVONDALE RD NE | ||||||||
| Address2: | SOUND MENTAL HEALTH -AVONDALE | ||||||||
| City: | REDMOND | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980522201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4256535070 | ||||||||
| FaxNumber: | 4256535071 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2007 | ||||||||
| LastUpdateDate: | 01/11/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WR0006X | NA00064464 | WA | N | Nursing Service Providers | Registered Nurse | Registered Nurse First Assistant | 101YM0800X | CG60139560 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.