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General NPI Number Information
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NPI Number | 1184405052
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Entity Type | Organization
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Legal Business Name | EVIDENCE BASED THERAPY SOLUTIONS
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Dates
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Enumeration Date | 10/09/2023
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 1380 112TH AVE NE STE 101
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City | BELLEVUE
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State | WA
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Zip | 98004-3759
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Country | US
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Telephone | 425-202-5439
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Fax |
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Provider Business Mailing Address
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Address Line | 10351 NE 10TH ST APT 1804
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City | BELLEVUE
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State | WA
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Zip | 98004-4798
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Country | US
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Telephone | 425-202-5439
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CASEY MCGINNIS
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Credential | PHD
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Telephone | 425-202-5439
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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