Healthcare Provider Details

I. General information

NPI: 1205591682
Provider Name (Legal Business Name): THERAPY INTO ACTION, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2021
Last Update Date: 11/01/2021
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 WESTLAKE AVE N STE 206
SEATTLE WA
98109-2764
US

IV. Provider business mailing address

13116 229TH AVE SE
ISSAQUAH WA
98027-8504
US

V. Phone/Fax

Practice location:
  • Phone: 206-282-1699
  • Fax: 206-962-3166
Mailing address:
  • Phone: 206-282-1699
  • Fax: 206-962-3166

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. MARISA ADRIANA KALLMAN
Title or Position: OWNER
Credential: MA, LMHC, CP
Phone: 206-282-1699