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General NPI Number Information
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NPI Number | 1811342793
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Entity Type | Individual
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Provider Name | TODD HOLDRIDGE LMFTA
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Gender | Male
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Dates
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Enumeration Date | 04/28/2016
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Last Update Date | 04/28/2016
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Provider Practice Location Address
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Address Line | 1315 N 160TH ST
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City | SHORELINE
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State | WA
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Zip | 98133-5751
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Country | US
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Telephone | 206-566-8519
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Fax |
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Provider Business Mailing Address
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Address Line | 2352 N 194TH ST
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City | SHORELINE
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State | WA
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Zip | 98133-4142
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Country | US
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Telephone | 206-574-8372
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MG60650509
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License Number State | WA
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