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General NPI Number Information
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NPI Number | 1710333612
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Entity Type | Organization
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Legal Business Name | KARIS COLLECTIVE
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Dates
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Enumeration Date | 05/10/2016
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Last Update Date | 05/10/2016
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Provider Practice Location Address
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Address Line | 7808 PACIFIC AVE SUITE 8
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City | TACOMA
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State | WA
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Zip | 98408-7039
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Country | US
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Telephone | 206-747-9604
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Fax |
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Provider Business Mailing Address
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Address Line | 7808 PACIFIC AVE SUITE 8
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City | TACOMA
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State | WA
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Zip | 98408-7039
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Country | US
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Telephone | 206-747-9604
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHARISSA WALSON
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Credential |
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Telephone | 206-747-9604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH 60488004
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License Number State | WA
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