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General NPI Number Information
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NPI Number | 1336536945
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Entity Type | Organization
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Legal Business Name | SYNERGOS - MARRIAGE & FAMILY THERAPY LLC
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Dates
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Enumeration Date | 04/21/2015
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 7406 27TH ST W STE 26
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4636
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Country | US
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Telephone | 253-318-6134
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Fax |
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Provider Business Mailing Address
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Address Line | 7406 27TH ST W STE 26
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City | UNIVERSITY PLACE
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State | WA
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Zip | 98466-4636
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Country | US
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Telephone | 253-318-6134
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM LEE WOEHL
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Credential | LMFT
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Telephone | 253-318-6134
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF 60124552
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License Number State | WA
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