Individual
MIRTHA EBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
122 16TH AVE E, SEATTLE, WA 98112-5212
(206) 302-2700
Mailing address
6400 SOUTHCENTER BLVD, TUKWILA, WA 98188-2547
(206) 901-2000
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/11/2019
Last updated
04/13/2022
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