Healthcare Provider Details

I. General information

NPI: 1669113866
Provider Name (Legal Business Name): EMPTY HANDS THERAPY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2022
Last Update Date: 04/05/2022
Certification Date: 04/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18518 BOTHELL WAY NE
BOTHELL WA
98011-1978
US

IV. Provider business mailing address

18518 BOTHELL WAY NE
BOTHELL WA
98011-1978
US

V. Phone/Fax

Practice location:
  • Phone: 425-780-6243
  • Fax:
Mailing address:
  • Phone: 425-780-6243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHELSI LYNNE HOUSE
Title or Position: OWNER/MENTAL HEALTH COUNSELOR
Credential: LMHC
Phone: 206-452-9375