Provider Demographics
NPI:1578893160
Name:FREMONT COMMUNITY THERAPY PROJECT
Entity Type:Organization
Organization Name:FREMONT COMMUNITY THERAPY PROJECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-633-2405
Mailing Address - Street 1:3429 FREMONT PL N
Mailing Address - Street 2:STE 319
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8660
Mailing Address - Country:US
Mailing Address - Phone:206-633-2405
Mailing Address - Fax:206-547-5298
Practice Address - Street 1:3417 FREMONT AVE N
Practice Address - Street 2:STE 225
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3411
Practice Address - Country:US
Practice Address - Phone:206-633-2405
Practice Address - Fax:206-547-5298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-05
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health