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General NPI Number Information
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NPI Number | 1316505316
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Entity Type | Organization
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Legal Business Name | INSPIRED LIFE THERAPY
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Dates
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Enumeration Date | 06/04/2019
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Last Update Date | 02/01/2024
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Provider Practice Location Address
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Address Line | 140 LAKESIDE AVE # A73
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City | SEATTLE
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State | WA
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Zip | 98122-6551
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Country | US
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Telephone | 775-298-5392
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Fax | 206-316-1357
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Provider Business Mailing Address
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Address Line | 140 LAKESIDE AVE # A73
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City | SEATTLE
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State | WA
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Zip | 98122-6551
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Country | US
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Telephone | 775-298-5392
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Fax | 206-316-1357
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZANDI ROSE SALSTROM
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Credential | ATR-BC, LMHC, LCPC
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Telephone | 775-298-5392
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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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