Healthcare Provider Details

I. General information

NPI: 1720920945
Provider Name (Legal Business Name): EMPOWERED PATHWAYS PNW, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2026
Last Update Date: 04/07/2026
Certification Date: 04/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 6TH AVE S STE 203
SEATTLE WA
98108-2510
US

IV. Provider business mailing address

5700 6TH AVE S STE 203
SEATTLE WA
98108-2510
US

V. Phone/Fax

Practice location:
  • Phone: 808-419-8105
  • Fax:
Mailing address:
  • Phone: 808-419-8105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: LISA M. FANNING
Title or Position: OWNER/PSYCHOTHERAPIST
Credential: LMHC
Phone: 808-419-8105