Healthcare Provider Details

I. General information

NPI: 1447533765
Provider Name (Legal Business Name): SEAN ORPEN LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 W GOWE ST
KENT WA
98032-5892
US

IV. Provider business mailing address

325 W GOWE ST
KENT WA
98032-5892
US

V. Phone/Fax

Practice location:
  • Phone: 253-205-0561
  • Fax: 253-735-9974
Mailing address:
  • Phone: 253-205-0561
  • Fax: 253-735-9974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLF60210018
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: