Provider Demographics
NPI:1699368217
Name:HEALING & EMPOWERING LIFE-COACHING & PSYCHOLOGICAL SERVICES
Entity Type:Organization
Organization Name:HEALING & EMPOWERING LIFE-COACHING & PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PETHYBRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:253-257-5177
Mailing Address - Street 1:8407 234TH AVE E
Mailing Address - Street 2:
Mailing Address - City:BUCKLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98321-9432
Mailing Address - Country:US
Mailing Address - Phone:253-257-5177
Mailing Address - Fax:
Practice Address - Street 1:8407 234TH AVE E
Practice Address - Street 2:
Practice Address - City:BUCKLEY
Practice Address - State:WA
Practice Address - Zip Code:98321-9432
Practice Address - Country:US
Practice Address - Phone:253-257-5177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty