Basic Information
| Provider Information | |||||||||
| NPI: | 1598948481 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MUNSON | ||||||||
| FirstName: | PAUL | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | BA, RC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 325 9TH AVE | ||||||||
| Address2: | BOX 359797 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981042420 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067449690 | ||||||||
| FaxNumber: | 2067449920 | ||||||||
| Practice Location | |||||||||
| Address1: | 401 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981227302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067449690 | ||||||||
| FaxNumber: | 2067449920 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2007 | ||||||||
| LastUpdateDate: | 12/13/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | RC00017782 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YM0800X | RC00017782 | WA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.