Provider Demographics
NPI:1447407283
Name:PAXTON, LINDA BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:BETH
Last Name:PAXTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:LINDA
Other - Middle Name:BETH
Other - Last Name:PROKOP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1611 116TH AVE NE
Mailing Address - Street 2:SUITE 227
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3045
Mailing Address - Country:US
Mailing Address - Phone:206-459-4456
Mailing Address - Fax:425-814-9362
Practice Address - Street 1:1611 116TH AVE NE
Practice Address - Street 2:SUITE 227
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3045
Practice Address - Country:US
Practice Address - Phone:206-459-4456
Practice Address - Fax:425-814-9362
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-22
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005597101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health