Healthcare Provider Details
I. General information
NPI: 1487585261
Provider Name (Legal Business Name): GROUNDED GROWTH THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
707 S SNOQUALMIE ST STE 5A
SEATTLE WA
98108-1742
US
IV. Provider business mailing address
707 S SNOQUALMIE ST STE 5A
SEATTLE WA
98108-1742
US
V. Phone/Fax
- Phone: 785-806-9708
- Fax:
- Phone: 785-806-9708
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0801X |
| Taxonomy | Mental Health Clinic/Center (Including Community Mental Health Center) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MADISON
GALLIANO
Title or Position: LMHC/OWNER
Credential:
Phone: 253-256-5132