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ADVENTURE PSYCHOTHERAPY, PLLC

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Company Details

Legal Name: ADVENTURE PSYCHOTHERAPY, PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Delinquent
Formation/ Registration Date: June 22nd 2023
Expiration date: 30 Jun 2025
UBI Number: 605 274 167
ZIP code: 98362
City: Port Angeles
County: CLALLAM
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 215 W 5TH ST, PORT ANGELES, WA, 98362-2811, UNITED STATES

Contact Details

E-Mail: ADVENTUREPSYCHOTHERAPY@GMAIL.COM
Phone Number: +1 360-582-6032

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
LISA V. HUNT Registered Agent 215 W 5TH ST, PORT ANGELES, WA, 98362-2811, UNITED STATES

Key Officers & Management

Name Role Address
LISA HUNT Governing Person -
MARK GASKILL EXECUTOR 215 W 5TH ST, PORT ANGELES, WA, 98362-2811, UNITED STATES

National Provider Identifier

NPI Number:
1154107027
Certification Date:
2024-03-20

Authorized Person:

Name:
MARK GASKILL
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QM0850X - Adult Mental Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QM0855X - Adolescent and Children Mental Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
106H00000X - Marriage & Family Therapist
Is Primary:
Yes

Contacts:

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