Provider Demographics
NPI:1184384273
Name:DASALLA, DARLENE
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:
Last Name:DASALLA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 4TH AVE APT 207
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2051
Mailing Address - Country:US
Mailing Address - Phone:559-273-5554
Mailing Address - Fax:
Practice Address - Street 1:2201 4TH AVE APT 207
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2051
Practice Address - Country:US
Practice Address - Phone:559-273-5554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-30
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61413487101YM0800X
LH61667357101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health