Provider Demographics
NPI:1255680005
Name:BOOTZ, MARGARET CHRISTINE (MA, CDP)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:CHRISTINE
Last Name:BOOTZ
Suffix:
Gender:F
Credentials:MA, CDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 CLIFFSIDE LN NW
Mailing Address - Street 2:F-302
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1685
Mailing Address - Country:US
Mailing Address - Phone:360-789-3803
Mailing Address - Fax:
Practice Address - Street 1:635 SW 154TH ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2220
Practice Address - Country:US
Practice Address - Phone:360-789-3803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60277747101YM0800X
WACP00004449101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional