Provider Demographics
NPI:1073020079
Name:PEOPLE BLOOM COUNSELING, PLLC
Entity Type:Organization
Organization Name:PEOPLE BLOOM COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ADA
Authorized Official - Middle Name:K
Authorized Official - Last Name:PANG
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:206-457-3518
Mailing Address - Street 1:8201 164TH AVE NE STE 200
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7615
Mailing Address - Country:US
Mailing Address - Phone:206-457-3518
Mailing Address - Fax:844-965-9483
Practice Address - Street 1:8201 164TH AVE NE STE 200
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7615
Practice Address - Country:US
Practice Address - Phone:206-457-3518
Practice Address - Fax:844-965-9483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-29
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty