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General NPI Number Information
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NPI Number | 1841149291
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Entity Type | Organization
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Legal Business Name | WATERHAWK INTEGRATED THERAPIES LLC
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 950 BROADWAY STE 303
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City | TACOMA
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State | WA
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Zip | 98402-4454
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Country | US
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Telephone | 253-213-3434
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Fax |
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Provider Business Mailing Address
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Address Line | 4910 N BRISTOL ST
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City | TACOMA
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State | WA
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Zip | 98407-2124
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Country | US
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Telephone | 253-314-8925
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | CHRISTINA VANDENBERG
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Credential | LMHC
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Telephone | 253-314-8925
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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 |
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License Number State |
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