Provider Demographics
NPI:1578187829
Name:THERAPY NORTHWEST PLLC
Entity Type:Organization
Organization Name:THERAPY NORTHWEST PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTERS
Authorized Official - Suffix:
Authorized Official - Credentials:MA LMHC
Authorized Official - Phone:425-449-3466
Mailing Address - Street 1:22525 SE 64TH PL STE 2277
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5383
Mailing Address - Country:US
Mailing Address - Phone:360-930-9380
Mailing Address - Fax:
Practice Address - Street 1:22525 SE 64TH PL STE 2277
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5383
Practice Address - Country:US
Practice Address - Phone:360-930-9380
Practice Address - Fax:425-278-7765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty