Provider Demographics
NPI:1952961682
Name:DIVERSITY OUTREACH
Entity type:Organization
Organization Name:DIVERSITY OUTREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RACHEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:425-422-7351
Mailing Address - Street 1:5007 99TH ST SW
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-4239
Mailing Address - Country:US
Mailing Address - Phone:425-422-7351
Mailing Address - Fax:
Practice Address - Street 1:2722 COLBY AVE STE 520
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-6600
Practice Address - Country:US
Practice Address - Phone:425-422-7351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty