=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851101091
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TWO PINES THERAPY, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/09/2025
-----------------------------------------------------
Last Update Date | 01/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 1ST AVE STE 102
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98104-2287
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-234-9967
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 600 1ST AVE STE 102 #2228
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-234-9967
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER/THERAPIST
-----------------------------------------------------
Name | MELISSA A MYERS
-----------------------------------------------------
Credential | LMHC
-----------------------------------------------------
Telephone | 206-234-9967
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------