Provider Demographics
NPI:1386765634
Name:FOHR, DEBORAH M (MS)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:M
Last Name:FOHR
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:J
Other - Last Name:MORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:533 E POINTES DR W
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:WA
Mailing Address - Zip Code:98584-9419
Mailing Address - Country:US
Mailing Address - Phone:425-672-0414
Mailing Address - Fax:425-672-0414
Practice Address - Street 1:533 E POINTES DR W
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:WA
Practice Address - Zip Code:98584-9419
Practice Address - Country:US
Practice Address - Phone:425-672-0414
Practice Address - Fax:425-672-0414
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002074106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist