| Fireweed Therapy, Pllc | |
|
10090 Main St Apt H Peshastin WA 98847-9770 | |
| (509) 676-6009 | |
| (509) 676-6009 |
| Full Name | Fireweed Therapy, Pllc |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 10090 Main St Apt H, Peshastin, Washington |
| Authorized Official Name and Position | Maile Grace Davelaar (OWNER) |
| Authorized Official Contact | 5096766009 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fireweed Therapy, Pllc 9041 Derby Canyon Rd Peshastin WA 98847-9754 Ph: (509) 679-8749 | Fireweed Therapy, Pllc 10090 Main St Apt H Peshastin WA 98847-9770 Ph: (509) 676-6009 |
| NPI Number | 1821564063 |
|---|---|
| Provider Enumeration Date | 10/15/2018 |
| Last Update Date | 10/15/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821564063 | NPI | - | NPPES |
| 1366758864 | Other | PERSONAL NPI | |
| 2050159 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |