Provider Demographics
NPI:1700114204
Name:HARARI, MILCAH
Entity Type:Individual
Prefix:MRS
First Name:MILCAH
Middle Name:
Last Name:HARARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13451 SE 36TH ST
Mailing Address - Street 2:FACTORIA MEDICAL CENTER
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-1454
Mailing Address - Country:US
Mailing Address - Phone:425-562-1350
Mailing Address - Fax:425-562-3802
Practice Address - Street 1:1 S PROSPECT ST
Practice Address - Street 2:ARNOLD 3
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-3456
Practice Address - Country:US
Practice Address - Phone:802-847-2648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-23
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW605610191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical