Provider Demographics
NPI:1386354330
Name:NORTH SOUND MENTAL WELLNESS
Entity type:Organization
Organization Name:NORTH SOUND MENTAL WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MISHELE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RUTHERFORD
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:206-743-1020
Mailing Address - Street 1:5005 200TH ST SW STE B
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6679
Mailing Address - Country:US
Mailing Address - Phone:206-636-1211
Mailing Address - Fax:425-678-0434
Practice Address - Street 1:5005 200TH ST SW STE B
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6679
Practice Address - Country:US
Practice Address - Phone:206-636-1211
Practice Address - Fax:425-678-0434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty