Provider Demographics
NPI:1518554278
Name:CULTIVATE THERAPY PLLC
Entity Type:Organization
Organization Name:CULTIVATE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA VALERIE
Authorized Official - Middle Name:LIM
Authorized Official - Last Name:YRANELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-382-8735
Mailing Address - Street 1:1037 NE 65TH ST # 82124
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-6655
Mailing Address - Country:US
Mailing Address - Phone:425-382-8735
Mailing Address - Fax:
Practice Address - Street 1:355 118TH AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-3554
Practice Address - Country:US
Practice Address - Phone:425-382-8735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-29
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health