Provider Demographics
NPI:1457625949
Name:DUMEZ-MATHESON, FRED RAY (LMHC)
Entity Type:Individual
Prefix:MR
First Name:FRED
Middle Name:RAY
Last Name:DUMEZ-MATHESON
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:FRED
Other - Middle Name:RAY
Other - Last Name:MATHESON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:19504 8TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-2554
Mailing Address - Country:US
Mailing Address - Phone:206-569-4937
Mailing Address - Fax:
Practice Address - Street 1:1914 N 34TH ST STE 504
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-9007
Practice Address - Country:US
Practice Address - Phone:206-569-4937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60525325101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health