Provider Demographics
NPI:1912414863
Name:TREEN, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:TREEN
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 1:905 DEXTER AVE N APT 522
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-3884
Mailing Address - Country:US
Mailing Address - Phone:315-717-8787
Mailing Address - Fax:
Practice Address - Street 1:10215 LAKE CITY WAY NE STE H
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7758
Practice Address - Country:US
Practice Address - Phone:206-417-9904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-01
Last Update Date:2018-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA201713591WAMedicaid