Provider Demographics
NPI:1033138334
Name:GRAHAM, DOUGLAS FRASER (LMHC)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:FRASER
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16425 266TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-6936
Mailing Address - Country:US
Mailing Address - Phone:206-901-1185
Mailing Address - Fax:
Practice Address - Street 1:23800 SE KENT KANGLEY RD
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-6848
Practice Address - Country:US
Practice Address - Phone:206-901-1185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00003684101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health