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General NPI Number Information
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NPI Number | 1588942700
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Entity Type | Organization
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Legal Business Name | TERRA THERAPY P.C.
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Dates
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Enumeration Date | 07/22/2011
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Last Update Date | 07/22/2011
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Provider Practice Location Address
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Address Line | 600 1ST AVE STE 435
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City | SEATTLE
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State | WA
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Zip | 98104-2216
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Country | US
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Telephone | 206-890-4858
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Fax |
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Provider Business Mailing Address
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Address Line | 600 1ST AVE STE 435
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City | SEATTLE
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State | WA
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Zip | 98104-2216
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Country | US
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Telephone | 206-890-4858
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | MS. CARY L TERRA
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Credential | LMFT
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Telephone | 206-890-4858
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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 | LF60079424
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License Number State | CA
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