Mortenson, Mitchel James

Mortenson, Mitchel James is an individual health care provider with primary practice located at 2204 Pacific Ave N , Long Beach WA 98631-3300. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Peer Specialist. Other Service Providers / Peer Specialist is his primary health care specialty. Mortenson, Mitchel James can be contacted via phone (360) 642-3787.

Contact Information

Primary practice address
2204 Pacific Ave N Long Beach WA 98631-3300
Phone: (360) 642-3787
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Washington
Other Service Providers / Peer Specialist 175T00000X

Profile Details

NPI number 1962170910
LBN Legal business name Mortenson, Mitchel James
Credentials AAC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2021
Last updated Nov 21st, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1962170910 NPPES
Washington MEDICAID 1760008783

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