Provider Demographics
NPI:1720717804
Name:WELL THOUGHT, PLLC
Entity Type:Organization
Organization Name:WELL THOUGHT, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARETH
Authorized Official - Middle Name:
Authorized Official - Last Name:PENTA
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, ARNP, PMHNP-BC
Authorized Official - Phone:360-559-3456
Mailing Address - Street 1:880 11TH AVENUE
Mailing Address - Street 2:SUITE #201
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:880 11TH AVENUE
Practice Address - Street 2:SUITE #201
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632
Practice Address - Country:US
Practice Address - Phone:360-355-6015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty