Healthcare Provider Details

I. General information

NPI: 1992600290
Provider Name (Legal Business Name): MIND AND MOTION THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 STEWART ST # 426
SEATTLE WA
98101-1230
US

IV. Provider business mailing address

31405 41ST AVE SW
FEDERAL WAY WA
98023-2115
US

V. Phone/Fax

Practice location:
  • Phone: 206-949-1527
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: ANNA WALLACE
Title or Position: OWNER
Credential: LMFTA
Phone: 206-949-1527