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NPI Code Detail

MEDICARE: PROFESSIONAL RESOURCE NETWORK 365, PLLC

MEDICARE: PROFESSIONAL RESOURCE NETWORK 365, 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
1106H00000XMarriage & Family Therapist

General Provider Information

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

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Directions to “PROFESSIONAL RESOURCE NETWORK 365, PLLC ” Practice Location

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