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General NPI Number Information
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NPI Number | 1043180458
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Entity Type | Organization
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Legal Business Name | THERAHEARD LLC
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Dates
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Enumeration Date | 11/10/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 119 OYLER WAY
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City | ETHEL
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State | WA
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Zip | 98542-9700
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Country | US
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Telephone | 253-228-1768
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Fax | 360-443-7570
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Provider Business Mailing Address
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Address Line | 119 OYLER WAY
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City | ETHEL
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State | WA
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Zip | 98542-9700
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Country | US
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Telephone | 253-228-1768
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Fax | 360-443-7570
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Authorized Official
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Title or Position | THERAPIST
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Name | CHRISTINA FAJARDO
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Credential | LMHC
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Telephone | 253-228-1768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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