Healthcare Provider Details

I. General information

NPI: 1386509511
Provider Name (Legal Business Name): THEARANY ENG LMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5080 229TH AVE SE
ISSAQUAH WA
98029-9213
US

IV. Provider business mailing address

5080 229TH AVE SE
ISSAQUAH WA
98029-9213
US

V. Phone/Fax

Practice location:
  • Phone: 206-351-6394
  • Fax:
Mailing address:
  • Phone: 206-351-6394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: