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General NPI Number Information
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NPI Number | 1952948358
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Entity Type | Organization
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Legal Business Name | PROFESSIONAL RESOURCE NETWORK 365, PLLC
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Dates
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Enumeration Date | 12/04/2019
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Last Update Date | 07/06/2020
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Provider Practice Location Address
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Address Line | 400 UNION AVE SE STE 200
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City | OLYMPIA
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State | WA
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Zip | 98501-2060
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Country | US
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Telephone | 360-797-9741
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Fax |
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Provider Business Mailing Address
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Address Line | 400 UNION AVE SE STE 200
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City | OLYMPIA
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State | WA
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Zip | 98501-2060
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Country | US
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Telephone | 360-797-9741
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CINDY PERRYMAN
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Credential | LMFT
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Telephone | 360-797-9741
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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 |
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License Number State |
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