Provider Demographics
NPI:1558735829
Name:NORTHWEST FAMILY THERAPY PLLC
Entity Type:Organization
Organization Name:NORTHWEST FAMILY THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RUTHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-659-6521
Mailing Address - Street 1:1836 WESTLAKE AVE N
Mailing Address - Street 2:SUITE 300B
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-2755
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1836 WESTLAKE AVE N
Practice Address - Street 2:SUITE 300B
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-2755
Practice Address - Country:US
Practice Address - Phone:206-659-6521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-24
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60582626101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty