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General NPI Number Information
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NPI Number | 1922509694
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Entity Type | Individual
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Provider Name | DAVID WEIDENBORNER LMHC
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Gender | Male
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Dates
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Enumeration Date | 02/27/2018
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 32808 145TH PL SE
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City | AUBURN
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State | WA
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Zip | 98092-5976
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Country | US
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Telephone | 206-395-4131
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Fax |
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Provider Business Mailing Address
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Address Line | 11 3RD ST NW #1421
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City | AUBURN
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State | WA
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Zip | 98071
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Country | US
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Telephone | 206-395-4131
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH61204561
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 009471
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License Number State | NY
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