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General NPI Number Information
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NPI Number | 1205591682
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Entity Type | Organization
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Legal Business Name | THERAPY INTO ACTION, PLLC
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Dates
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Enumeration Date | 11/01/2021
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Last Update Date | 11/01/2021
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Provider Practice Location Address
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Address Line | 1800 WESTLAKE AVE N STE 206
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City | SEATTLE
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State | WA
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Zip | 98109-2764
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Country | US
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Telephone | 206-282-1699
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Fax | 206-962-3166
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Provider Business Mailing Address
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Address Line | 13116 229TH AVE SE
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City | ISSAQUAH
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State | WA
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Zip | 98027-8504
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Country | US
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Telephone | 206-282-1699
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Fax | 206-962-3166
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARISA ADRIANA KALLMAN
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Credential | MA, LMHC, CP
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Telephone | 206-282-1699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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