Provider Demographics
NPI:1235170630
Name:DENBOER, MELANIE LIANA (LMFT)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:LIANA
Last Name:DENBOER
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:PO BOX 1226
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-1226
Mailing Address - Country:US
Mailing Address - Phone:425-577-3828
Mailing Address - Fax:425-883-9707
Practice Address - Street 1:7981 168TH AVE NE STE 208
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-0911
Practice Address - Country:US
Practice Address - Phone:425-577-3828
Practice Address - Fax:425-883-9707
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002376106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist