Provider Demographics
NPI:1083329726
Name:GENERATIONS MENTAL HEALTH AND WELLNESS PLLC
Entity Type:Organization
Organization Name:GENERATIONS MENTAL HEALTH AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:IONATAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUNEAC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-923-8886
Mailing Address - Street 1:3211 117TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-8743
Mailing Address - Country:US
Mailing Address - Phone:206-923-8886
Mailing Address - Fax:
Practice Address - Street 1:3211 117TH AVE NE
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-8743
Practice Address - Country:US
Practice Address - Phone:206-923-8886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty