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General NPI Number Information
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NPI Number | 1376336974
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Entity Type | Organization
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Legal Business Name | HOPE AND HEALING CLINIC LLC
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Dates
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Enumeration Date | 05/27/2025
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 9474 LATHROP INDUSTRIAL DR SW
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City | TUMWATER
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State | WA
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Zip | 98512-1109
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Country | US
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Telephone | 360-583-3340
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Fax |
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Provider Business Mailing Address
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Address Line | 1887 WHITNEY MESA DR # 5589
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City | HENDERSON
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State | NV
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Zip | 89014-2069
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF NURSING OFFICER
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Name | THERESA STANLEY
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Credential |
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Telephone | 707-365-5178
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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