Healthcare Provider Details

I. General information

NPI: 1174442453
Provider Name (Legal Business Name): PATH TO GROWTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 AURORA AVE N STE 117
SEATTLE WA
98103-7853
US

IV. Provider business mailing address

4000 AURORA AVE N STE 117
SEATTLE WA
98103-7853
US

V. Phone/Fax

Practice location:
  • Phone: 585-662-8830
  • Fax:
Mailing address:
  • Phone: 585-662-8830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: BOAZ NZIKAMIRA
Title or Position: OWNER
Credential: CEO
Phone: 585-662-8830