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General NPI Number Information
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NPI Number | 1639045107
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Entity Type | Organization
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Legal Business Name | TAHOMAGLOW HEALING AND THERAPY COLLECTIVE
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Dates
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Enumeration Date | 10/13/2025
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Last Update Date | 10/13/2025
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Provider Practice Location Address
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Address Line | 2208 NW MARKET ST STE 502
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City | SEATTLE
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State | WA
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Zip | 98107-4098
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Country | US
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Telephone | 206-804-2122
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Fax | 206-970-5463
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Provider Business Mailing Address
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Address Line | 1501 NW 56TH ST APT 518
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City | SEATTLE
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State | WA
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Zip | 98107-5288
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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 | OWNER
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Name | DANIELA GUADALUPE GUERRERO
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Credential | LMHC
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Telephone | 206-804-2122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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