MEDICARE: FASEELA THERAPY, PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1841138146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FASEELA THERAPY, PLLC

Provider Business Mailing Address
First Line	:	2027 196TH ST SW STE A205
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-7073
Country	:	US
Telephone Number	:	425-541-7596
Fax Number	:

Provider Business Practice Location Address
First Line	:	2027 196TH ST SW STE A205
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-7073
Country	:	US
Telephone Number	:	425-541-7596
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RAIYA AL-ANSARI
Credential	:
Telephone Number	:	425-541-7596

Provider Enumeration Date	:	03/25/2026
Last Update Date	:	03/25/2026

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