Provider Demographics
NPI:1447970413
Name:DRAGONFLY LLC
Entity type:Organization
Organization Name:DRAGONFLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:R
Authorized Official - Last Name:SCHELLENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:425-628-3354
Mailing Address - Street 1:7345 164TH AVE NE STE 145-386
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-7846
Mailing Address - Country:US
Mailing Address - Phone:425-628-3354
Mailing Address - Fax:
Practice Address - Street 1:7345 164TH AVE NE STE 145-386
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-7846
Practice Address - Country:US
Practice Address - Phone:425-628-3354
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-30
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)