Provider Demographics
NPI:1538627773
Name:INSIGHT ALLIANCE PSYCHOTHERAPY, PC
Entity type:Organization
Organization Name:INSIGHT ALLIANCE PSYCHOTHERAPY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:PATRICIA
Authorized Official - Last Name:LABOUY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:206-930-6940
Mailing Address - Street 1:6741 NE 182ND ST UNIT C113
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-5009
Mailing Address - Country:US
Mailing Address - Phone:206-930-6940
Mailing Address - Fax:
Practice Address - Street 1:12537 15TH AVE NE STE 208
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-3979
Practice Address - Country:US
Practice Address - Phone:425-559-9565
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
1376709550OtherNPPES