Healthcare Provider Details
I. General information
NPI: 1376880286
Provider Name (Legal Business Name): SOUND PSYCHOTHERAPY & ASSESSMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/11/2013
Last Update Date: 09/15/2020
Certification Date: 09/15/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3515 SW ALASKA ST
SEATTLE WA
98126-2730
US
IV. Provider business mailing address
3515 SW ALASKA ST
SEATTLE WA
98126-2730
US
V. Phone/Fax
- Phone: 206-979-8787
- Fax: 206-309-3373
- Phone: 206-979-8787
- Fax: 206-309-3373
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | PY60039110 |
| License Number State | WA |
VIII. Authorized Official
Name: DR.
SIERRA
L
SWING
Title or Position: OWNER/CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 206-979-8787