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General NPI Number Information
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NPI Number | 1063861805
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Entity Type | Organization
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Legal Business Name | HOPERISING PSYCHOTHERAPY PLLC
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Dates
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Enumeration Date | 06/10/2016
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 7808 PACIFIC AVE STE 8
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City | TACOMA
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State | WA
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Zip | 98408-7039
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Country | US
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Telephone | 206-451-0937
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Fax |
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Provider Business Mailing Address
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Address Line | 7808 PACIFIC AVE STE 8
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City | TACOMA
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State | WA
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Zip | 98408-7039
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Country | US
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Telephone | 206-451-0937
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA LARSON
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Credential | MSW, LICSW
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Telephone | 206-451-0937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LW60491393
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License Number State | WA
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