Provider Demographics
NPI:1114150240
Name:SLOCUM, TREVOR J (MA)
Entity Type:Individual
Prefix:MR
First Name:TREVOR
Middle Name:J
Last Name:SLOCUM
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11447 71ST PL S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98178
Mailing Address - Country:US
Mailing Address - Phone:206-909-7345
Mailing Address - Fax:
Practice Address - Street 1:600 1ST AVE STE 531
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2229
Practice Address - Country:US
Practice Address - Phone:206-909-7345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00054378101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor