Provider Demographics
NPI:1942420153
Name:BOWEN, EILEEN M (MA)
Entity Type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:M
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10614 BEARDSLEE BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3279
Mailing Address - Country:US
Mailing Address - Phone:206-300-0859
Mailing Address - Fax:425-424-2384
Practice Address - Street 1:10614 BEARDSLEE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3279
Practice Address - Country:US
Practice Address - Phone:206-300-0859
Practice Address - Fax:425-424-2384
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-27
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60273538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health