Provider Demographics
NPI:1194590711
Name:DOUGLASS THERAPY AND ASSOCIATES
Entity type:Organization
Organization Name:DOUGLASS THERAPY AND ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:DOUGLASS PEERS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, SUDP
Authorized Official - Phone:253-432-4561
Mailing Address - Street 1:6625 WAGNER WAY STE 260C
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-8392
Mailing Address - Country:US
Mailing Address - Phone:253-432-4561
Mailing Address - Fax:
Practice Address - Street 1:6625 WAGNER WAY STE 260C
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335-8392
Practice Address - Country:US
Practice Address - Phone:253-432-4561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-24
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)