Basic Information
| Provider Information | |||||||||
| NPI: | 1679086292 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GONZALEZ-HAU ANAKOTTA | ||||||||
| FirstName: | MARIA | ||||||||
| MiddleName: | DELA LUZ | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | COUNSELOR | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ANAKOTTA | ||||||||
| OtherFirstName: | MARIA | ||||||||
| OtherMiddleName: | GONZALEZ-HAU | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | PO BOX 2569 | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982130569 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252124200 | ||||||||
| FaxNumber: | 4252124201 | ||||||||
| Practice Location | |||||||||
| Address1: | 811 MADISON ST | ||||||||
| Address2: | |||||||||
| City: | EVERETT | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982034543 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4252124200 | ||||||||
| FaxNumber: | 4252124201 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/06/2017 | ||||||||
| LastUpdateDate: | 11/06/2017 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | SC60795532 | WA | Y | Behavioral Health & Social Service Providers | Counselor |
No ID Information.