Healthcare Provider Details

I. General information

NPI: 1205588555
Provider Name (Legal Business Name): EASTSIDE INSIGHT, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2022
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

545 RAINIER BLVD N STE 11
ISSAQUAH WA
98027-2806
US

IV. Provider business mailing address

545 RAINIER BLVD N STE 11
ISSAQUAH WA
98027-2806
US

V. Phone/Fax

Practice location:
  • Phone: 425-245-5981
  • Fax:
Mailing address:
  • Phone: 425-245-5981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. AZARAH ROSE GILLIS
Title or Position: OWNER
Credential: M.A., LMHC
Phone: 425-245-5981