Basic Information
Provider Information
NPI: 1750662607
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DANSON
FirstName: NICOLE
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: BS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
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: 4719 12TH AVE NE
Address2: SOUND MENTAL HEALTH
City: SEATTLE
State: WA
PostalCode: 981055414
CountryCode: US
TelephoneNumber: 2063022676
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/06/2011
LastUpdateDate: 09/06/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000XCG60233766WAY Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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