Healthcare Provider Details

I. General information

NPI: 1982745709
Provider Name (Legal Business Name): LINDA K SKINNER MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2223 S MERIDIAN
PUYALLUP WA
98371-7503
US

IV. Provider business mailing address

2223 S MERIDIAN
PUYALLUP WA
98371-7503
US

V. Phone/Fax

Practice location:
  • Phone: 253-948-6497
  • Fax: 253-286-7540
Mailing address:
  • Phone: 253-948-6497
  • Fax: 253-286-7540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF00002625
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: