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General NPI Number Information
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NPI Number | 1679920680
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Entity Type | Organization
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Legal Business Name | RESOLVE THERAPY, LLC
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Dates
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Enumeration Date | 05/19/2016
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 345 118TH AVE SE SUITE 100
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City | BELLEVUE
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State | WA
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Zip | 98005-3587
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Country | US
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Telephone | 425-559-4148
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Fax | 425-968-0606
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Provider Business Mailing Address
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Address Line | 5524 157TH DR NE
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City | REDMOND
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State | WA
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Zip | 98052-5211
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Country | US
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Telephone | 425-559-4148
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Fax | 425-968-0606
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Authorized Official
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Title or Position | OWNER/PRACTITIONER
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Name | RYAN MEBUST
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Credential | MA, LMFT
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Telephone | 425-559-4148
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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 | LF60342352
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License Number State | WA
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