Provider Demographics
NPI:1043721459
Name:DONG, WENSI (LMFTA)
Entity Type:Individual
Prefix:
First Name:WENSI
Middle Name:
Last Name:DONG
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16275 NE 85TH ST STE H
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-0851
Mailing Address - Country:US
Mailing Address - Phone:206-377-9697
Mailing Address - Fax:
Practice Address - Street 1:2366 EASTLAKE AVE E STE 215
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-6501
Practice Address - Country:US
Practice Address - Phone:206-377-9697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-12
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60767141106H00000X
WALF61058584106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist