Healthcare Provider Details

I. General information

NPI: 1063326890
Provider Name (Legal Business Name): TRAVIS ADAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5702 N 26TH ST STE B
TACOMA WA
98407-2406
US

IV. Provider business mailing address

2200 CALIFORNIA AVE SW APT 202
SEATTLE WA
98116-2157
US

V. Phone/Fax

Practice location:
  • Phone: 253-292-1216
  • Fax:
Mailing address:
  • Phone: 253-431-8630
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: