Provider Demographics
NPI:1952948358
Name:PROFESSIONAL RESOURCE NETWORK 365, PLLC
Entity type:Organization
Organization Name:PROFESSIONAL RESOURCE NETWORK 365, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:PERRYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:360-797-9741
Mailing Address - Street 1:400 UNION AVE SE STE 200
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-2060
Mailing Address - Country:US
Mailing Address - Phone:360-797-9741
Mailing Address - Fax:
Practice Address - Street 1:400 UNION AVE SE STE 200
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-2060
Practice Address - Country:US
Practice Address - Phone:360-797-9741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROFESSIONAL RESOURCE NETWORK 365
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-04
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty