Provider Demographics
NPI:1497950711
Name:GHIONI, MARIO ALEXANDER (MA)
Entity Type:Individual
Prefix:MR
First Name:MARIO
Middle Name:ALEXANDER
Last Name:GHIONI
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14020 NE 84TH ST
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-1942
Mailing Address - Country:US
Mailing Address - Phone:425-765-5943
Mailing Address - Fax:
Practice Address - Street 1:1300 114TH AVE SE
Practice Address - Street 2:SUITE 108
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6942
Practice Address - Country:US
Practice Address - Phone:425-765-5943
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003786101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health