Healthcare Provider Details

I. General information

NPI: 1851295315
Provider Name (Legal Business Name): WINTERBERRY PSYCHOTHERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 S SHERIDAN AVE
TACOMA WA
98405-3452
US

IV. Provider business mailing address

100 N HOWARD ST STE R
SPOKANE WA
99201-0508
US

V. Phone/Fax

Practice location:
  • Phone: 253-722-6350
  • Fax:
Mailing address:
  • Phone: 253-722-6350
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: AUDREY OLIVER
Title or Position: OWNER AND SOLE MEMBER
Credential: LICSW
Phone: 253-722-6350