Healthcare Provider Details

I. General information

NPI: 1356704860
Provider Name (Legal Business Name): THRIVE INTEGRATIVE HEALTH PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2016
Last Update Date: 11/02/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 NW GILMAN BLVD STE 201
ISSAQUAH WA
98027-2722
US

IV. Provider business mailing address

PO BOX 3057
ISSAQUAH WA
98027-0137
US

V. Phone/Fax

Practice location:
  • Phone: 425-835-2503
  • Fax: 425-285-5436
Mailing address:
  • Phone: 425-835-2503
  • Fax: 425-285-5436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLF00002543
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC60434405
License Number StateWA
# 7
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MS. ENGRACIA THARP
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 425-835-2503