Provider Demographics
NPI:1891047395
Name:THROWER, EMITT LEE
Entity Type:Individual
Prefix:MR
First Name:EMITT
Middle Name:LEE
Last Name:THROWER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5801 23RD DR. W. #104
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-6853
Mailing Address - Country:US
Mailing Address - Phone:425-513-8213
Mailing Address - Fax:425-513-0534
Practice Address - Street 1:5801 23RD DR W STE 104
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-1587
Practice Address - Country:US
Practice Address - Phone:425-513-8213
Practice Address - Fax:425-513-0534
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-08
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
WA172V0000X172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No172V00000XOther Service ProvidersCommunity Health Worker