Healthcare Provider Details

I. General information

NPI: 1366512915
Provider Name (Legal Business Name): STEVEN JAMES WREN LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: STEVEN JAMES SCHUETZ/HALLORAN

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 01/19/2022
Certification Date: 01/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20720 111TH AVE SW
VASHON WA
98070
US

IV. Provider business mailing address

10005 SW 178TH ST. #1869
VASHON WA
98070
US

V. Phone/Fax

Practice location:
  • Phone: 206-217-4465
  • Fax: 206-217-4463
Mailing address:
  • Phone: 206-217-4465
  • Fax: 206-217-4463

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLH00006417
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: