Healthcare Provider Details

I. General information

NPI: 1083147599
Provider Name (Legal Business Name): LADONNA PUTMAN MS, LMHC, SUDP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13044 SHELLY ST SW
OLYMPIA WA
98512-9141
US

IV. Provider business mailing address

4800 COLLEGE ST SE
OLYMPIA WA
98503-4389
US

V. Phone/Fax

Practice location:
  • Phone: 360-878-7137
  • Fax:
Mailing address:
  • Phone: 360-493-7047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61294341
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: