Provider Demographics
NPI:1396346581
Name:INNER QUEST PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:INNER QUEST PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ELZA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOYCHEVA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:425-526-4141
Mailing Address - Street 1:300 LENORA ST # 622
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2411
Mailing Address - Country:US
Mailing Address - Phone:206-202-3015
Mailing Address - Fax:
Practice Address - Street 1:906 W 2ND AVE STE 100
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-4540
Practice Address - Country:US
Practice Address - Phone:425-526-4141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-04
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty