Provider Demographics
NPI:1598134595
Name:THIS TOO SHALL PASS
Entity Type:Organization
Organization Name:THIS TOO SHALL PASS
Other - Org Name:ACCOUNTABLE FUTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:PUEBLA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, CMHS
Authorized Official - Phone:360-809-2971
Mailing Address - Street 1:PO BOX 5828
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98312-0596
Mailing Address - Country:US
Mailing Address - Phone:360-809-2971
Mailing Address - Fax:
Practice Address - Street 1:9951 MICKELBERRY RD NW STE 137
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-8309
Practice Address - Country:US
Practice Address - Phone:888-868-6952
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-19
Last Update Date:2015-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 60107671103TC0700X
WALF 60300097106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty