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Organization

DEEP LAKE COUNSELING

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KRISTIN MOORE MAC, MED, MPA, LMHC (OWNER)
(206) 930-5901
Entity
Organization

Contact information

Practice address
561 E PASSAGE VIEW RD, SHELTON, WA 98584-4701
(206) 930-5901
Mailing address
1546 NE 94TH ST, SEATTLE, WA 98115-3148
(206) 930-5901

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
10/17/2025
Last updated
10/17/2025
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