Suite 430-J
2208 NW Market St
Seattle, WA 98107

Name *
Phone *
How do you prefer to be contacted?
Please let me know what you're interested in. If "Other", you may add this in your comment section.
Do not include confidential or private information regarding your health condition in this form or any other form found on this website.
If you are a student, we can discuss a sliding scale payment.
Release of Information *
Please visit to be informed of the HIPAA Privacy Rule.