Healthcare Provider Details

I. General information

NPI: 1265309389
Provider Name (Legal Business Name): SAGE PSYCHIATRIC AND WELLNESS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18460 E STATE ROUTE 3 STE 3
ALLYN WA
98524-8728
US

IV. Provider business mailing address

14580 NW HONEYHILL LOOP
SEABECK WA
98380-9730
US

V. Phone/Fax

Practice location:
  • Phone: 360-228-5576
  • Fax: 360-523-1770
Mailing address:
  • Phone: 360-551-0951
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. LALINE RILEY
Title or Position: APRN
Credential: PMHNP-BC
Phone: 360-551-0951