Inner Canvas Sp Pllc | |
108 S Jackson St Ste 301 Seattle WA 98104-2872 | |
(425) 526-9575 | |
Not Available |
Full Name | Inner Canvas Sp Pllc |
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Speciality | Marriage & Family Therapist |
Location | 108 S Jackson St Ste 301, Seattle, Washington |
Authorized Official Name and Position | Pamela Krueger (OWNER / PSYCHOTHERAPIST) |
Authorized Official Contact | 4255269575 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Inner Canvas Sp Pllc 2445 Squak Mountain Loop Sw Issaquah WA 98027-4423 Ph: (206) 356-5175 | Inner Canvas Sp Pllc 108 S Jackson St Ste 301 Seattle WA 98104-2872 Ph: (425) 526-9575 |
NPI Number | 1679320071 |
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Provider Enumeration Date | 05/02/2024 |
Last Update Date | 05/02/2024 |
Certification Date | 05/02/2024 |
Medicare PECOS PAC ID | 9739626177 |
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Medicare Enrollment ID | O20240803000178 |
Identifier | Type | State | Issuer |
---|---|---|---|
1679320071 | NPI | - | NPPES |
Provider Name | Pamela Krueger |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1093552234 PECOS PAC ID: 0648717082 Enrollment ID: I20240803000188 |
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