Doctor Name: | RAFFAEL BOCCAMAZZO |
NPI Number: | 1013357359 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | MC60383082 |
Business Practice Address: | 16307 Ne 83rd St Suite 201a Redmond, WA - 980521501 |
Business Phone Number: | 2062402676 |
Business Fax Number: | |
Mailing Address: | 4225 155th Pl Se, BELLEVUE |
State: | WA |
Postal Code: | 980062579 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/01/2013 |
NPI Last Update Date: | 07/01/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | MC60383082 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |