Provider Demographics
NPI:1396004503
Name:SIMONSEN, DAVID (PHD MS LMFT)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:SIMONSEN
Suffix:
Gender:M
Credentials:PHD MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2345 CARPENTER RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-3863
Mailing Address - Country:US
Mailing Address - Phone:360-280-9227
Mailing Address - Fax:
Practice Address - Street 1:1800 COOPER POINT RD SW STE 20B
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-1039
Practice Address - Country:US
Practice Address - Phone:360-280-9227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2019-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001940106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist