Mortensen, Trista Nicole
Mortensen, Trista Nicole is an sole proprietor health care provider with primary practice located at 304 Main Ave S Ste 102, Renton WA 98057-2758. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Mortensen, Trista Nicole can be contacted via phone (206) 697-3281.Contact Information
Primary practice address
304 Main Ave S Ste 102
Renton WA 98057-2758
Phone: (206) 697-3281
Fax: (206) 358-5753
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | LW60004175 | Washington |
Profile Details
| NPI number | 1720125636 |
|---|---|
| LBN Legal business name | Mortensen, Trista Nicole |
| Credentials | MSW |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Oct 1st, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720125636 | NPPES |
| Washington | MEDICAID | 2076299 |
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