Healthcare Provider Details

I. General information

NPI: 1144967209
Provider Name (Legal Business Name): INNER WELLNESS COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2022
Last Update Date: 05/19/2022
Certification Date: 05/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

634 7TH AVE
KIRKLAND WA
98033-5665
US

IV. Provider business mailing address

634 7TH AVE
KIRKLAND WA
98033-5665
US

V. Phone/Fax

Practice location:
  • Phone: 425-628-2999
  • Fax: 425-629-0444
Mailing address:
  • Phone: 425-628-2999
  • Fax: 425-629-0444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: OKSANA THOMPSON
Title or Position: BUSINESS OWNER AND MH CLINICIAN
Credential: LMHC, NCC, MHP
Phone: 425-628-2999