Healthcare Provider Details

I. General information

NPI: 1710843750
Provider Name (Legal Business Name): SOMA ROOTS THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2026
Last Update Date: 01/03/2026
Certification Date: 01/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

327 NE 5TH AVE STE B
CAMAS WA
98607-2030
US

IV. Provider business mailing address

327 NE 5TH AVE STE B
CAMAS WA
98607-2030
US

V. Phone/Fax

Practice location:
  • Phone: 360-218-5040
  • Fax:
Mailing address:
  • Phone: 360-218-5040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. DEL KNIGHT
Title or Position: OWNER & CLINICAL SUPERVISOR
Credential: PSYD, LPC, LMHC
Phone: 360-323-8904