Provider Demographics
NPI:1043989957
Name:HOPE DEVELOPMENT PRACTICE
Entity Type:Organization
Organization Name:HOPE DEVELOPMENT PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:360-770-2866
Mailing Address - Street 1:1011 E MAIN STE 103
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98372-6768
Mailing Address - Country:US
Mailing Address - Phone:360-770-2866
Mailing Address - Fax:253-309-3033
Practice Address - Street 1:1011 E MAIN STE 103
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98372-6768
Practice Address - Country:US
Practice Address - Phone:360-770-2866
Practice Address - Fax:253-309-3033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA604691709OtherUNIFIED BUSINESS ID