Healthcare Provider Details

I. General information

NPI: 1336876622
Provider Name (Legal Business Name): REACH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2022
Last Update Date: 08/05/2022
Certification Date: 08/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13646 NE 24TH ST
BELLEVUE WA
98005-1859
US

IV. Provider business mailing address

14935 NE 87TH ST STE 160
REDMOND WA
98052-2046
US

V. Phone/Fax

Practice location:
  • Phone: 425-298-3840
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: AMY LATHROP
Title or Position: MANAGING DIRECTOR
Credential: LMHCA, MS
Phone: 425-298-3840