Organization
CREATIVE CHANGE COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAVIDA LEIGHTON LISCW (COUNSELOR)
(425) 255-5526
Entity
Organization
Contact information
Practice address
200 S TOBIN ST STE A, RENTON, WA 98057-5338
(425) 255-5526
(425) 255-5523
Mailing address
PO BOX 4158, RENTON, WA 98057-4158
(425) 255-5526
(425) 255-5523
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW00006856
WA
Other
Enumeration date
06/30/2014
Last updated
06/30/2014
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