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Organization
EARTH STAR LLC
Active
Organization
EARTH STAR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVAN KIMBLE (OWNER)
(206) 380-0368
Entity
Organization
Contact information
Practice address
2829 NE 113TH ST, SEATTLE, WA 98125-6744
(206) 380-0368
Mailing address
2319 N 45TH ST, SUITE 211, SEATTLE, WA 98103-6982
(206) 380-0368
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LH60083354
WA
225700000X
Massage Therapist
MA00005295
WA
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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