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General NPI Number Information
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NPI Number | 1982007464
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Entity Type | Individual
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Provider Name | DANIEL LEE DEWAELSCHE M.A., MHC
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Gender | Male
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Dates
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Enumeration Date | 09/29/2014
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 3516 S 47TH ST SUITE 200
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City | TACOMA
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State | WA
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Zip | 98409-4452
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Country | US
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Telephone | 253-475-9442
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Fax | 253-475-9452
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Provider Business Mailing Address
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Address Line | 3516 S 47TH ST SUITE 200
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City | TACOMA
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State | WA
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Zip | 98409-4452
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Country | US
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Telephone | 253-475-9442
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Fax | 253-475-9452
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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 | LH60153708
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License Number State | WA
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