Provider Demographics
NPI:1326193228
Name:DOUGLAS, DEBRA GRIFFIN (MA, LMFT)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:GRIFFIN
Last Name:DOUGLAS
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 1:3121 E MADISON ST STE 208A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4260
Mailing Address - Country:US
Mailing Address - Phone:425-681-7595
Mailing Address - Fax:
Practice Address - Street 1:3121 E MADISON ST STE 208A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4260
Practice Address - Country:US
Practice Address - Phone:425-681-7595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001171106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist