Provider Demographics
NPI:1376125849
Name:SONDER PSYCHOTHERAPY PLLC
Entity Type:Organization
Organization Name:SONDER PSYCHOTHERAPY PLLC
Other - Org Name:MERRILL SHATTUCK LMHC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MERRILL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHATTUCK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:206-317-8287
Mailing Address - Street 1:1400 112TH AVE SE STE 202
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6901
Mailing Address - Country:US
Mailing Address - Phone:206-317-8287
Mailing Address - Fax:
Practice Address - Street 1:1400 112TH AVE SE STE 202
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6901
Practice Address - Country:US
Practice Address - Phone:206-317-8287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-24
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)