Provider Demographics
NPI:1386233484
Name:FIRM FOUNDATIONS FAMILY THERAPY
Entity type:Organization
Organization Name:FIRM FOUNDATIONS FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:253-312-3520
Mailing Address - Street 1:1902 NORMA RD NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-1343
Mailing Address - Country:US
Mailing Address - Phone:253-312-3520
Mailing Address - Fax:
Practice Address - Street 1:1902 NORMA RD NE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98422-1343
Practice Address - Country:US
Practice Address - Phone:253-312-3520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)