Provider Demographics
NPI:1316141112
Name:WEED, DAVID EVAN (MA LMHC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:EVAN
Last Name:WEED
Suffix:
Gender:M
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12301 NE 10TH PL
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2487
Mailing Address - Country:US
Mailing Address - Phone:425-746-7338
Mailing Address - Fax:
Practice Address - Street 1:12301 NE 10TH PL
Practice Address - Street 2:SUITE 301
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2487
Practice Address - Country:US
Practice Address - Phone:425-746-7338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008760101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health