| Doctor Name: | MARY ANTHONY |
| NPI Number: | 1356723431 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MA, LMHCA |
| License Number: | MC60469501 |
| Business Practice Address: | 16840 Bothell Way Ne Lake Forest Park, WA - 981555645 |
| Business Phone Number: | 2067900864 |
| Business Fax Number: | |
| Mailing Address: | 18281 58th Ave Ne, KENMORE |
| State: | WA |
| Postal Code: | 980288719 |
| Phone Number: | 2067900864 |
| Fax Number: | |
| NPI Enumeration Date: | 06/24/2015 |
| NPI Last Update Date: | 06/24/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | MC60469501 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |