MEDICARE: WENSI DONG LMFTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist	MG60767141	WA
2	106H00000X	Marriage & Family Therapist	LF61058584	WA

General Provider Information

NPI Number	:	1043721459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENSI DONG LMFTA

Provider Business Mailing Address
First Line	:	16275 NE 85TH ST STE H
Second Line	:
City	:	REDMOND
State	:	WA
Zip	:	98052-0851
Country	:	US
Telephone Number	:	206-377-9697
Fax Number	:

Provider Business Practice Location Address
First Line	:	2366 EASTLAKE AVE E STE 215
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98102-6501
Country	:	US
Telephone Number	:	206-377-9697
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2017
Last Update Date	:	11/18/2020

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Directions to “ WENSI DONG LMFTA” Practice Location

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