Provider Demographics
NPI:1538817754
Name:ADVANCED THERAPY SOLUTIONS NW, INC
Entity type:Organization
Organization Name:ADVANCED THERAPY SOLUTIONS NW, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:JASMINE
Authorized Official - Last Name:WHILEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMP, CLT
Authorized Official - Phone:360-990-9511
Mailing Address - Street 1:PO BOX 1716
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:WA
Mailing Address - Zip Code:98346-1716
Mailing Address - Country:US
Mailing Address - Phone:360-990-9511
Mailing Address - Fax:360-208-0604
Practice Address - Street 1:572 N 5TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3079
Practice Address - Country:US
Practice Address - Phone:360-990-9511
Practice Address - Fax:360-208-0604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty