Provider Demographics
NPI:1912446527
Name:PACIFIC COUNSELING AND RESEARCH CENTER
Entity Type:Organization
Organization Name:PACIFIC COUNSELING AND RESEARCH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:PAAVOLA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:847-873-2741
Mailing Address - Street 1:225 CEDAR ST
Mailing Address - Street 2:2501
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-5200
Mailing Address - Country:US
Mailing Address - Phone:847-873-2741
Mailing Address - Fax:
Practice Address - Street 1:1700 NW GILMAN BLVD
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5349
Practice Address - Country:US
Practice Address - Phone:206-508-4330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-15
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60695956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty