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Organization
WINCORP WIDEWORLD
Active
Organization
WINCORP WIDEWORLD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP GENE ANDERSON ED.D., LMHC (DIRECTOR)
(206) 772-2200
Entity
Organization
Contact information
Practice address
126 SW 148TH ST, C100 STE 203, BURIEN, WA 98166-1984
(206) 772-2200
(425) 361-1643
Mailing address
126 SW 148TH ST, C100 STE 203, BURIEN, WA 98166-1984
(206) 772-2200
(425) 361-1643
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH00004610
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26271014
BCBS OF KC IDENTIFIER
MO
01
—
AN1027
RIDER NUMBER FOR REGENCE
WA
Enumeration date
02/07/2007
Last updated
08/22/2020
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