Healthcare Provider Details

I. General information

NPI: 1104575711
Provider Name (Legal Business Name): RISE THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2022
Last Update Date: 03/21/2022
Certification Date: 03/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 OLIVE WAY STE 204
SEATTLE WA
98101-1726
US

IV. Provider business mailing address

813 32ND AVE
SEATTLE WA
98122-5103
US

V. Phone/Fax

Practice location:
  • Phone: 206-329-5255
  • Fax:
Mailing address:
  • Phone: 206-999-3391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK H. MEYER
Title or Position: PSYCHOLOGIST
Credential: PSY.D.
Phone: 206-329-5255