Individual
ANNIE VANG IMOTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3805 108TH AVE NE STE 204, BELLEVUE, WA 98004-7613
(425) 242-1713
Mailing address
3805 108TH AVE NE STE 204, BELLEVUE, WA 98004-7613
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
61555016
WA
Other
Enumeration date
03/09/2023
Last updated
03/17/2025
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