Healthcare Provider Details

I. General information

NPI: 1013835370
Provider Name (Legal Business Name): CASCADIA PSYCHODYNAMIC TRAINING CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9656 WATERS AVE S
SEATTLE WA
98118-5955
US

IV. Provider business mailing address

127 ABBOTTS ALY
SEDRO WOOLLEY WA
98284-8826
US

V. Phone/Fax

Practice location:
  • Phone: 360-630-1663
  • Fax:
Mailing address:
  • Phone: 360-630-1663
  • Fax:

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: MS. ISAAC EKBLAD
Title or Position: OWNER
Credential: LMHC
Phone: 360-630-1663