Healthcare Provider Details

I. General information

NPI: 1861292971
Provider Name (Legal Business Name): SOUND REIGN OPTIMAL BEHAVIORAL HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1721 HEWITT AVE STE 504
EVERETT WA
98201-3546
US

IV. Provider business mailing address

1721 HEWITT AVE STE 504
EVERETT WA
98201-3546
US

V. Phone/Fax

Practice location:
  • Phone: 425-200-5153
  • Fax:
Mailing address:
  • Phone: 425-200-5153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: REGINAH NAMPINGA
Title or Position: PMHNP-BC
Credential: ARNP
Phone: 425-200-5153