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General NPI Number Information
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NPI Number | 1093176265
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Entity Type | Organization
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Legal Business Name | HARBOR CHILD AND FAMILY THERAPY, PLLC
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Dates
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Enumeration Date | 03/15/2016
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Last Update Date | 03/15/2016
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Provider Practice Location Address
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Address Line | 6625 WAGNER WAY NW SUITE 250
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City | GIG HARBOR
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State | WA
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Zip | 98335-8392
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Country | US
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Telephone | 253-208-4258
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Fax |
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Provider Business Mailing Address
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Address Line | 3210 42ND AVE NW
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City | GIG HARBOR
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State | WA
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Zip | 98335-8036
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Country | US
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Telephone | 253-208-4258
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | DAVID B WALKER
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Credential | LMFT
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Telephone | 253-208-4258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF00001897
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License Number State | WA
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