Provider Demographics
NPI:1306816814
Name:FAMILY MARRIAGE AND ASSESSMENT COUNSELING, LLC
Entity type:Organization
Organization Name:FAMILY MARRIAGE AND ASSESSMENT COUNSELING, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:STOOKEY
Authorized Official - Last Name:FINWALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-589-1611
Mailing Address - Street 1:PO BOX 24603
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98093-1603
Mailing Address - Country:US
Mailing Address - Phone:253-589-1611
Mailing Address - Fax:253-589-1544
Practice Address - Street 1:7424 BRIDGEPORT WAY W
Practice Address - Street 2:SUITE 309
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8120
Practice Address - Country:US
Practice Address - Phone:253-589-1611
Practice Address - Fax:253-589-1544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-25
Last Update Date:2011-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB36614Medicare ID - Type UnspecifiedGPIN