Healthcare Provider Details

I. General information

NPI: 1770237612
Provider Name (Legal Business Name): SOUND HEART PSYCHOLOGY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2022
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2118 CATON WAY SW
OLYMPIA WA
98502-1105
US

IV. Provider business mailing address

2118 CATON WAY SW
OLYMPIA WA
98502-1105
US

V. Phone/Fax

Practice location:
  • Phone: 360-951-4009
  • Fax: 360-352-3289
Mailing address:
  • Phone: 360-951-4009
  • Fax: 360-352-3289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MOLLY O'NEIL
Title or Position: OWNER
Credential: PSYD
Phone: 360-951-4009