NPI 1659765816

Eastside Social Skills Therapy LLC

Organisation Preferred Provider Organization Issaquah, WA

Practice location

Address: 5436 232nd Ave SE, Issaquah, WA 98029
Phone: (206) 380-3009

Authorised official

Name: Penny J Lathum
Title: Owner
Phone: (206) 380-3009

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

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Registry record

NPI: 1659765816
Entity type: Organization
NPI issued: 26 Mar 2015
Record last updated: 26 Mar 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.