Provider Demographics
NPI:1174651962
Name:PRAXIN INC.
Entity Type:Organization
Organization Name:PRAXIN INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:OMALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA,LMHC,CDP,CCFC
Authorized Official - Phone:425-454-9490
Mailing Address - Street 1:1800 112TH AVE NE STE 260E
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2937
Mailing Address - Country:US
Mailing Address - Phone:425-454-9490
Mailing Address - Fax:425-454-9490
Practice Address - Street 1:1800 112TH AVE NE STE 260E
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2937
Practice Address - Country:US
Practice Address - Phone:425-454-9490
Practice Address - Fax:425-454-9490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA17-120800101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty