| Fairfax Hospital Inc | |
|
1711 12th Ave Seattle WA 98122-2435 | |
| (206) 375-5872 | |
| Not Available |
| Full Name | Fairfax Hospital Inc |
|---|---|
| Speciality | Art Therapist |
| Location | 1711 12th Ave, Seattle, Washington |
| Authorized Official Name and Position | Joanne Marie Della Penta (ART THERAPIST) |
| Authorized Official Contact | 4258212000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax Hospital Inc 1729 12th Ave Apt 110 Seattle WA 98122-2492 Ph: (206) 783-6850 | Fairfax Hospital Inc 1711 12th Ave Seattle WA 98122-2435 Ph: (206) 375-5872 |
| NPI Number | 1588702526 |
|---|---|
| Provider Enumeration Date | 02/02/2007 |
| Last Update Date | 09/11/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588702526 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | RC00053238 (Washington) | Secondary |
| 221700000X | Art Therapist | 05-019 (North Carolina) | Primary |
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