Healthcare Provider Details

I. General information

NPI: 1063141398
Provider Name (Legal Business Name): ISABELLE NORA MINCH MSMFT WA LMFTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2022
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31919 1ST AVE S STE 105
FEDERAL WAY WA
98003-5258
US

IV. Provider business mailing address

31919 1ST AVE S STE 105
FEDERAL WAY WA
98003-5258
US

V. Phone/Fax

Practice location:
  • Phone: 425-200-4491
  • Fax:
Mailing address:
  • Phone: 425-200-4491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTA.MG.70084729
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: