Healthcare Provider Details

I. General information

NPI: 1932715943
Provider Name (Legal Business Name): RACHELE MARIE BRADY LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: RACHELE MARIE JOHNSON

II. Dates (important events)

Enumeration Date: 09/16/2020
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2620 R W JOHNSON BLVD SW STE 204
TUMWATER WA
98512-6133
US

IV. Provider business mailing address

PO BOX 284
LITTLEROCK WA
98556-0284
US

V. Phone/Fax

Practice location:
  • Phone: 360-358-2252
  • Fax:
Mailing address:
  • Phone: 360-358-2252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLF.61464341
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF.61464341
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: