Provider Demographics
NPI:1871958967
Name:SISKIWIT BAY COUNSELING, PLLC
Entity type:Organization
Organization Name:SISKIWIT BAY COUNSELING, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCHULTE
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:651-226-2910
Mailing Address - Street 1:154 THORNE ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-3143
Mailing Address - Country:US
Mailing Address - Phone:651-226-2910
Mailing Address - Fax:
Practice Address - Street 1:128 N 2ND AVE
Practice Address - Street 2:SUITE 209
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-0042
Practice Address - Country:US
Practice Address - Phone:509-525-1725
Practice Address - Fax:509-525-9054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC 605141851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty