Healthcare Provider Details

I. General information

NPI: 1669308599
Provider Name (Legal Business Name): THE TEN5 GROUP. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 6TH AVE N APT 9
SEATTLE WA
98109-3937
US

IV. Provider business mailing address

13215 SE MILL PLAIN BLVD STE C8
VANCOUVER WA
98684-6999
US

V. Phone/Fax

Practice location:
  • Phone: 929-990-7729
  • Fax:
Mailing address:
  • Phone: 929-990-7729
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: SAUBAH NAKYANJA
Title or Position: CEO
Credential:
Phone: 929-990-7729