Healthcare Provider Details

I. General information

NPI: 1689509754
Provider Name (Legal Business Name): WELLSPRING THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W SPRUCE ST STE 30
YAKIMA WA
98902-3264
US

IV. Provider business mailing address

906 E LINCOLN AVE
YAKIMA WA
98901-2546
US

V. Phone/Fax

Practice location:
  • Phone: 509-834-8191
  • Fax: 509-834-8191
Mailing address:
  • Phone: 509-834-8191
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: ANTHONY LEE PAUL
Title or Position: OWNER
Credential: LMHC
Phone: 509-834-8191