Healthcare Provider Details

I. General information

NPI: 1538880745
Provider Name (Legal Business Name): MARIAN MAYA THOMPSON LMFTA, BHSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MAYA DAJON BHSS

II. Dates (important events)

Enumeration Date: 09/06/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE # 6924
SPOKANE WA
99201-0580
US

IV. Provider business mailing address

2355 WESTWOOD BLVD UNIT 205
LOS ANGELES CA
90064-2109
US

V. Phone/Fax

Practice location:
  • Phone: 323-205-5436
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFTA.MG.70142686
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: