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Mr. Eduardo Medina JR., LMHCA,SUDP
Counselor in Tukwila, Washington
NPI 1487166146

Eduardo Medina JR. is a Counselor based in Longview, WA. Eduardo Medina JR. practices in Tukwila, WA and has the professional credentials of LMHCA,SUDP. The NPI Number for Eduardo Medina JR. is 1487166146 and holds a License No. CP61085939 (Washington).

The current practice location address for Eduardo Medina JR. is 15455 65Th Ave S, Tukwila, WA and can be reached out via phone at 206-721-5170 and via fax at 360-353-9440.

Location: 15455 65Th Ave S, Tukwila, WA, 98632-8486
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487166146
Provider Name
Eduardo Medina JR.
Credential
LMHCA,SUDP
Provider Entity Type
Individual
Gender
Male
Address
15455 65Th Ave S, Tukwila, WA, 98632-8486
Phone Number
206-721-5170
Fax Number
360-353-9440
Provider Enumeration Date
11/02/2017
Last Update Date
08/17/2024
institution
Provider Business Practice Location Address Details
Address
15455 65Th Ave S
City
Tukwila
State
Washington
Zip
98188-2534
Phone Number
206-721-5170
Fax Number
360-353-9440
person
Provider Business Mailing Address Details
Address
15455 65Th Ave S
City
Tukwila
State
Washington
Zip
98188-2534
Phone Number
206-721-5170
Fax Number
360-353-9440
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
101Y00000X
License No.
MC61477391 (Washington)
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
CP61085939 (Washington)
Definition
Definition to come...
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