Healthcare Provider Details

I. General information

NPI: 1043603905
Provider Name (Legal Business Name): VIVOMOMENTIS, PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2015
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4122 FACTORIA BLVD SE STE 405
BELLEVUE WA
98006-5259
US

IV. Provider business mailing address

4122 FACTORIA BLVD SE STE 405
BELLEVUE WA
98006-5259
US

V. Phone/Fax

Practice location:
  • Phone: 425-242-6267
  • Fax:
Mailing address:
  • Phone: 425-242-6267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCO60281317
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60492836
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF60521657
License Number StateWA

VIII. Authorized Official

Name: MELANIE D VALLEE
Title or Position: PRESIDENT
Credential: MA, LMFT, LMHC, PHDC
Phone: 425-389-1427