| Organization Name: | RITES OF PASSAGE NW LLC |
| NPI Number: | 1053701854 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | NATHAN A WELCH (DIRECTOR) |
| Mailing Address: | 142 E Strong Rd Shelton |
| State: | WA US |
| Postal Code: | 985848861 |
| Phone Number: | 3602963040 |
| Fax Number: | 6504563040 |
| NPI Enumeration Date: | 01/31/2015 |
| NPI Last Update Date: | 01/31/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LH60258150 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |