Provider Demographics
NPI:1326441924
Name:SIMKINS SLUK THERAPY
Entity Type:Organization
Organization Name:SIMKINS SLUK THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMKINS SLUK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:425-224-6679
Mailing Address - Street 1:650 NW 84TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3141
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3400 HARBOR AVE SW
Practice Address - Street 2:#437
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-2394
Practice Address - Country:US
Practice Address - Phone:206-790-2364
Practice Address - Fax:888-972-7936
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-27
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60456396106H00000X
WALF60402154106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty