Provider Demographics
NPI:1760601223
Name:MAITRI INSTITUTE, PLLC
Entity Type:Organization
Organization Name:MAITRI INSTITUTE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER, THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ZBOYAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:425-688-8585
Mailing Address - Street 1:1309 114TH AVE SE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6903
Mailing Address - Country:US
Mailing Address - Phone:425-688-8585
Mailing Address - Fax:425-637-1150
Practice Address - Street 1:1309 114TH AVE SE
Practice Address - Street 2:SUITE 210
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6903
Practice Address - Country:US
Practice Address - Phone:425-688-8585
Practice Address - Fax:425-637-1150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001096106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALF00001096OtherSTATE L.M.F.T. LICENSE