Basic Information
Provider Information
NPI: 1518486596
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WELCH
FirstName: SCOTT
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6200 14TH AVE NW
Address2:  
City: SEATTLE
State: WA
PostalCode: 981072280
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 3320 173RD PL NE
Address2:  
City: ARLINGTON
State: WA
PostalCode: 982238712
CountryCode: US
TelephoneNumber: 4253498700
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/11/2017
LastUpdateDate: 06/28/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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