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General NPI Number Information
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NPI Number | 1215647201
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Entity Type | Organization
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Legal Business Name | PURSUIT MENTAL HEALTH AND RECOVERY
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Dates
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Enumeration Date | 11/30/2022
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Last Update Date | 04/30/2025
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Provider Practice Location Address
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Address Line | 707 S GRADY WAY STE 600
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City | RENTON
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State | WA
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Zip | 98057-3227
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Country | US
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Telephone | 206-588-5251
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Fax | 206-238-9564
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Provider Business Mailing Address
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Address Line | 8297 CHAMPIONS GATE BLVD STE 240
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City | CHAMPIONS GATE
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State | FL
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Zip | 33896-8387
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Country | US
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Telephone | 206-588-5251
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | STEPHEN DOUGLAS MARTIN
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Credential | NP
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Telephone | 951-312-9646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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