Provider Demographics
NPI:1073164463
Name:SOUND SOMATIC THERAPY, PLLC
Entity Type:Organization
Organization Name:SOUND SOMATIC THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SISSON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:206-399-4761
Mailing Address - Street 1:4533 13TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-2321
Mailing Address - Country:US
Mailing Address - Phone:206-399-4761
Mailing Address - Fax:888-460-0392
Practice Address - Street 1:4533 13TH AVE SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-2321
Practice Address - Country:US
Practice Address - Phone:360-930-9838
Practice Address - Fax:888-460-0392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-26
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)