Provider Demographics
NPI:1174652424
Name:HILL, MYRNA L (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:MYRNA
Middle Name:L
Last Name:HILL
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 NE BAKER HILL RD
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-2000
Mailing Address - Country:US
Mailing Address - Phone:360-536-1112
Mailing Address - Fax:360-824-9024
Practice Address - Street 1:18657 STATE HIGHWAY 305 NE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8418
Practice Address - Country:US
Practice Address - Phone:360-536-1121
Practice Address - Fax:360-536-1121
Is Sole Proprietor?:No
Enumeration Date:2007-03-05
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60283691106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist