Provider Demographics
NPI:1104223619
Name:WILLIAMS, LAURA (MHCA)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6916 S 115TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178-3013
Mailing Address - Country:US
Mailing Address - Phone:206-371-2086
Mailing Address - Fax:
Practice Address - Street 1:306 WELLS AVE S UNIT E
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-2786
Practice Address - Country:US
Practice Address - Phone:206-371-2086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60350042101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health