Healthcare Provider Details

I. General information

NPI: 1770910861
Provider Name (Legal Business Name): HARTSSPACE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2013
Last Update Date: 06/05/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 CATON WAY SW STE 102
OLYMPIA WA
98502-1176
US

IV. Provider business mailing address

2116 CATON WAY SW STE 102
OLYMPIA WA
98502-1176
US

V. Phone/Fax

Practice location:
  • Phone: 360-915-2151
  • Fax: 360-754-2145
Mailing address:
  • Phone: 360-915-2151
  • Fax: 360-754-2145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU60040674
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberNU60334795
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH 60138935
License Number StateWA

VIII. Authorized Official

Name: KATHERINE (KATIE) ROSE HART
Title or Position: AUTHORIZED OFFICIAL,MANAGING MEMBER
Credential: LMHC, CN
Phone: 360-915-2151