MEDICARE: FIVES THERAPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1790441343
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIVES THERAPY

Provider Business Mailing Address
First Line	:	250 GAGE BLVD APT 4027
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-8656
Country	:	US
Telephone Number	:	936-701-6126
Fax Number	:

Provider Business Practice Location Address
First Line	:	250 GAGE BLVD APT 4027
Second Line	:
City	:	RICHLAND
State	:	WA
Zip	:	99352-8656
Country	:	US
Telephone Number	:	936-701-6126
Fax Number	:

Authorized Official
Title or Position	:	THERAPIST
Name	:	SHANNON F STRINGER
Credential	:	LMFT
Telephone Number	:	281-757-4282

Provider Enumeration Date	:	11/09/2021
Last Update Date	:	11/09/2021

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Directions to “FIVES THERAPY ” Practice Location

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