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General NPI Number Information
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NPI Number | 1306388079
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Entity Type | Organization
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Legal Business Name | SEATTLE THERAPY GROUP, PLLC
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Dates
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Enumeration Date | 11/13/2016
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Last Update Date | 11/13/2016
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Provider Practice Location Address
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Address Line | 1700 7TH AVE SUITE 2100
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City | SEATTLE
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State | WA
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Zip | 98101-1397
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Country | US
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Telephone | 206-357-8483
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 7TH AVE SUITE 2100
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City | SEATTLE
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State | WA
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Zip | 98101-1397
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Country | US
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Telephone | 206-357-8483
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER/MEMBER
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Name | MRS. KIMBERLY SLAGLE
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Credential |
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Telephone | 206-357-8483
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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 | LF60494036
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License Number State | WA
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