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TRAUMA THERAPY NORTHWEST PLLC

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Company Details

Legal Name: TRAUMA THERAPY NORTHWEST PLLC
Jurisdiction: WASHINGTON
Entity Type: WA PROFESSIONAL LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: November 3rd 2021
Expiration date: 30 Nov 2025
UBI Number: 604 833 408
ZIP code: 99201
City: Spokane
County: SPOKANE
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 422 W RIVERSIDE AVE STE 518, SPOKANE, WA, 99201-0302, UNITED STATES

Contact Details

E-Mail: ROGER.YODER@THERAPYSPOKANE.COM

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
ROGER YODER Registered Agent 422 W RIVERSIDE AVE STE 518, SPOKANE, WA, 99201-0302, UNITED STATES

Key Officers & Management

Name Role Address
ROGER YODER Executor 422 W RIVERSIDE AVE STE 518, SPOKANE, WA, 99201-0302, UNITED STATES
ROGER YODER Governing Person 422 W RIVERSIDE AVE STE 501, SPOKANE, WA, 99201-0302, UNITED STATES
TERESE MEDINA Governing Person -

National Provider Identifier

NPI Number:
1861157810
Certification Date:
2021-11-04

Authorized Person:

Name:
JESSICA CAMPBELL
Role:
CLINICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
101YM0800X - Mental Health Counselor
Is Primary:
Yes

Contacts:

Fax:
8887417039
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