Organization
JOYFUL AWAKENING PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HORIZON GREENE LICSW (OWNER, PROVIDER)
(971) 258-2971
Entity
Organization
Contact information
Practice address
5623 RAINIER AVE S, SEATTLE, WA 98118-2442
(971) 258-2971
Mailing address
PO BOX 28442, SEATTLE, WA 98118-8442
(971) 258-2971
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912204546
—
WA
Enumeration date
08/23/2021
Last updated
08/23/2021
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