Healthcare Provider Details

I. General information

NPI: 1417889189
Provider Name (Legal Business Name): BALANCED PATHWAYS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4405 7TH AVE SE STE 200
LACEY WA
98503-1055
US

IV. Provider business mailing address

4405 7TH AVE SE STE 200
LACEY WA
98503-1055
US

V. Phone/Fax

Practice location:
  • Phone: 360-218-4558
  • Fax:
Mailing address:
  • Phone: 360-218-4558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KATE TEAGUE
Title or Position: BILLING AND CREDENTIALING
Credential:
Phone: 360-209-4216