Healthcare Provider Details

I. General information

NPI: 1265361554
Provider Name (Legal Business Name): SEATTLE SENIOR THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2910 E MADISON ST STE 110
SEATTLE WA
98112-4214
US

IV. Provider business mailing address

2910 E MADISON ST STE 110
SEATTLE WA
98112-4214
US

V. Phone/Fax

Practice location:
  • Phone: 206-291-9059
  • Fax:
Mailing address:
  • Phone: 206-291-9059
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: DANIEL J DEVITO
Title or Position: OWNER
Credential:
Phone: 206-291-9059