Provider Demographics
NPI:1457830184
Name:DEVRIES, DEBORAH L (MA, LMHCA)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:L
Last Name:DEVRIES
Suffix:
Gender:F
Credentials:MA, LMHCA
Other - Prefix:
Other - First Name:DEBBIE
Other - Middle Name:L
Other - Last Name:DEVRIES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMHCA
Mailing Address - Street 1:28313 REDONDO WAY S APT 104
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-8256
Mailing Address - Country:US
Mailing Address - Phone:206-552-0574
Mailing Address - Fax:
Practice Address - Street 1:28313 REDONDO WAY S APT 104
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-8256
Practice Address - Country:US
Practice Address - Phone:206-552-0574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61068101101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health