Organization Active NPI

Pacific Roots Therapy, PLLC

  • Mental Health Counselor
  • Puyallup, WA
National Provider Identifier
1427862689
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
PACIFIC ROOTS THERAPY, PLLC
Practice address
104 W Meeker Ste B
Puyallup, WA 98371-8901
Phone
(541) 953-8249
NPI assigned
Feb 6, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bethany Alice Marie SuttonNPI 1831512268
Title
Ma, LMFT
Phone
(541) 953-8249

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

104 W Meeker Ste B
Puyallup, WA 98371-8901

Mailing address

104 W Meeker Ste B
Puyallup, WA 98371-8901
Phone (541) 953-8249

National Provider Directory

National Provider Directory

Locations

104 W Meeker
Ste B
Puyallup, WA 98371
Phone (206) 992-2304

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1738800000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738800000000",
    "number": "1427862689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W MEEKER STE B",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983718901",
            "telephone_number": "541-953-8249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W MEEKER STE B",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983718901",
            "telephone_number": "541-953-8249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACIFIC ROOTS THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-06",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "BETHANY",
        "authorized_official_middle_name": "ALICE MARIE",
        "authorized_official_title_or_position": "MA, LMFT",
        "authorized_official_telephone_number": "541-953-8249"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.