Provider Demographics
NPI:1427503689
Name:AVERY FISHER THERAPY
Entity type:Organization
Organization Name:AVERY FISHER THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PSYCHOTHERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AVERY
Authorized Official - Middle Name:CLARK
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:206-852-9992
Mailing Address - Street 1:226 SUMMIT AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-5619
Mailing Address - Country:US
Mailing Address - Phone:206-852-9992
Mailing Address - Fax:
Practice Address - Street 1:226 SUMMIT AVE E
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-5619
Practice Address - Country:US
Practice Address - Phone:206-852-9992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-17
Last Update Date:2016-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60579078251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health