Healthcare Provider Details
I. General information
NPI: 1154022390
Provider Name (Legal Business Name): GROWTH AND HEALING PSYCHOLOGICAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/14/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
401 BROADWAY STE 10096827
TACOMA WA
98402-3900
US
IV. Provider business mailing address
401 BROADWAY STE 10096827
TACOMA WA
98402-3900
US
V. Phone/Fax
- Phone: 206-339-7327
- Fax:
- Phone: 425-364-6604
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
KATHLEEN
KING
Title or Position: PRESIDENT
Credential: PHD
Phone: 425-364-6604