| Vital Changes, Inc | |
|
451 Sw 10th Street Suite 108 Renton WA 98057 | |
| (425) 687-9600 | |
| (425) 264-0136 |
| Full Name | Vital Changes, Inc |
|---|---|
| Speciality | Counselor |
| Location | 451 Sw 10th Street, Renton, Washington |
| Authorized Official Name and Position | David A Mcfarlane (PRESIDENT) |
| Authorized Official Contact | 4256879600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Changes, Inc 451 Sw 10th Street Suite 108 Renton WA 98057 Ph: (425) 687-9600 | Vital Changes, Inc 451 Sw 10th Street Suite 108 Renton WA 98057 Ph: (425) 687-9600 |
| NPI Number | 1386823441 |
|---|---|
| Provider Enumeration Date | 10/25/2007 |
| Last Update Date | 04/22/2009 |
| Medicare PECOS PAC ID | 6507916236 |
|---|---|
| Medicare Enrollment ID | O20090618000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386823441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| Provider Name | David A Mcfarlane |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033204565 PECOS PAC ID: 2163529546 Enrollment ID: I20091023000653 |
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