MEDICARE: MR. ROBERT WAYNE PARHAM JR. LMHC

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	101YM0800X	Mental Health Counselor	LH00007800	WA

General Provider Information

NPI Number	:	1477752418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT WAYNE PARHAM JR. LMHC

Provider Business Mailing Address
First Line	:	622 TACOMA AVE S
Second Line	:	SUITE 3
City	:	TACOMA
State	:	WA
Zip	:	98402-2319
Country	:	US
Telephone Number	:	253-691-5472
Fax Number	:	253-572-9958

Provider Business Practice Location Address
First Line	:	622 TACOMA AVE S
Second Line	:	SUITE 3
City	:	TACOMA
State	:	WA
Zip	:	98402-2319
Country	:	US
Telephone Number	:	253-691-5472
Fax Number	:	253-572-9958

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

Provider Enumeration Date	:	07/11/2007
Last Update Date	:	07/11/2007

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