Provider Demographics
NPI:1164893962
Name:OLSEN, WENDY L (LMFT)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:OLSEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4742 42ND AVE SW
Mailing Address - Street 2:#602
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4553
Mailing Address - Country:US
Mailing Address - Phone:206-876-0342
Mailing Address - Fax:
Practice Address - Street 1:630 SW 149TH ST
Practice Address - Street 2:#101
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1901
Practice Address - Country:US
Practice Address - Phone:206-876-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001279106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist