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General NPI Number Information
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NPI Number | 1568211217
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Entity Type | Organization
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Legal Business Name | HUMANISTIC THERAPY NW
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Dates
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Enumeration Date | 05/15/2024
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 9240 TACOMA AVE S
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City | TACOMA
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State | WA
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Zip | 98444-6140
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Country | US
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Telephone | 253-370-8980
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Fax | 503-966-0849
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Provider Business Mailing Address
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Address Line | 9240 TACOMA AVE S
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City | TACOMA
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State | WA
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Zip | 98444-6140
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Country | US
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Telephone | 253-368-3255
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Fax | 503-966-0849
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Authorized Official
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Title or Position | OWNER
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Name | JEFFREY ALLEN KIILSGAARD
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Credential | LCSW. LICSW, ACSW
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Telephone | 253-368-3255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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