Provider Demographics
NPI:1306388079
Name:SEATTLE THERAPY GROUP, PLLC
Entity Type:Organization
Organization Name:SEATTLE THERAPY GROUP, PLLC
Other - Org Name:SEATTLE THERAPY GROUP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER/MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:SLAGLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-357-8483
Mailing Address - Street 1:1700 7TH AVE
Mailing Address - Street 2:SUITE 2100
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1397
Mailing Address - Country:US
Mailing Address - Phone:206-357-8483
Mailing Address - Fax:
Practice Address - Street 1:1700 7TH AVE
Practice Address - Street 2:SUITE 2100
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1397
Practice Address - Country:US
Practice Address - Phone:206-357-8483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-13
Last Update Date:2016-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60494036101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty