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General NPI Number Information
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NPI Number | 1336385897
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Entity Type | Individual
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Provider Name | COLLEEN ANNE YOUNG MA
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Gender | Female
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 04/24/2017
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Provider Practice Location Address
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Address Line | 2622 MCCARVER ST.
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City | TACOMA
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State | WA
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Zip | 98403
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Country | US
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Telephone | 253-576-7896
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Fax |
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Provider Business Mailing Address
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Address Line | 9 ST. HELEN'S AVE STE C
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City | TACOMA
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State | WA
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Zip | 98402
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Country | US
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Telephone | 253-576-7896
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Fax | 866-579-4088
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | RC60044983
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LF 60258087
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License Number State | WA
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