Healthcare Provider Details

I. General information

NPI: 1043579352
Provider Name (Legal Business Name): SILVIA R BEHREND D. MIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2012
Last Update Date: 02/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 WEST BAY DR NW SUITE102
OLYMPIA WA
98502-4668
US

IV. Provider business mailing address

1107 WEST BAY DR NW SUITE 102
OLYMPIA WA
98502-4668
US

V. Phone/Fax

Practice location:
  • Phone: 360-943-9591
  • Fax:
Mailing address:
  • Phone: 360-943-9591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: