Healthcare Provider Details

I. General information

NPI: 1497131247
Provider Name (Legal Business Name): PATHWAYS MENTAL HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

436 MCPHEE RD SW
OLYMPIA WA
98502-5014
US

IV. Provider business mailing address

436 MCPHEE RD SW
OLYMPIA WA
98502-5014
US

V. Phone/Fax

Practice location:
  • Phone: 360-799-5782
  • Fax:
Mailing address:
  • Phone: 360-799-5782
  • Fax:

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 Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number#LH00008672
License Number StateWA

VIII. Authorized Official

Name: ARTHUR TOLENTINO
Title or Position: PATHWAYS MHS CLINICAL DIRECTOR
Credential:
Phone: 360-799-5782