Healthcare Provider Details

I. General information

NPI: 1659879690
Provider Name (Legal Business Name): MOLLESTON LUKE COUNSELING LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 10/28/2025
Certification Date: 10/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 E PIONEER STE 213
PUYALLUP WA
98372-3320
US

IV. Provider business mailing address

5114 POINT FOSDICK DR STE F #220
GIG HARBOR WA
98335
US

V. Phone/Fax

Practice location:
  • Phone: 253-330-7204
  • Fax: 253-387-8151
Mailing address:
  • Phone: 253-330-7204
  • Fax: 253-387-8151

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: MRS. ALEXANDRA EVE MOLLESTON LUKE
Title or Position: PRESIDENT
Credential: LMFT
Phone: 253-224-3432