Provider Demographics
NPI:1215093323
Name:DALE, KURT L (LMFT)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:L
Last Name:DALE
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:KURTIS
Other - Middle Name:L
Other - Last Name:DALE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7813 12TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4320
Mailing Address - Country:US
Mailing Address - Phone:206-264-5081
Mailing Address - Fax:
Practice Address - Street 1:7813 12TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4320
Practice Address - Country:US
Practice Address - Phone:206-264-5081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001103106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist