Provider Demographics
NPI:1235599549
Name:TATE, WENDY LEE (MS, LMHC)
Entity Type:Individual
Prefix:MS
First Name:WENDY
Middle Name:LEE
Last Name:TATE
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 182ND AVE E UNIT C
Mailing Address - Street 2:
Mailing Address - City:LAKE TAPPS
Mailing Address - State:WA
Mailing Address - Zip Code:98391-5704
Mailing Address - Country:US
Mailing Address - Phone:253-455-1676
Mailing Address - Fax:253-470-3990
Practice Address - Street 1:314 182ND AVE E UNIT C
Practice Address - Street 2:
Practice Address - City:LAKE TAPPS
Practice Address - State:WA
Practice Address - Zip Code:98391-5704
Practice Address - Country:US
Practice Address - Phone:253-455-1676
Practice Address - Fax:253-470-3990
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60884936101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health