Provider Demographics
NPI:1467757021
Name:KING, DI MARIE (MSW, MHP)
Entity Type:Individual
Prefix:MS
First Name:DI
Middle Name:MARIE
Last Name:KING
Suffix:
Gender:F
Credentials:MSW, MHP
Other - Prefix:
Other - First Name:DI
Other - Middle Name:MARIE
Other - Last Name:DAUGHERTY - KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, MHP
Mailing Address - Street 1:1600 E OLIVE ST
Mailing Address - Street 2:SOUND MENTAL HEALTH
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2735
Mailing Address - Country:US
Mailing Address - Phone:206-302-2200
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:6100 SOUTHCENTER BLVD
Practice Address - Street 2:SOUND MENTAL HEALTH, SUITE 200
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-2441
Practice Address - Country:US
Practice Address - Phone:206-444-7953
Practice Address - Fax:206-444-7810
Is Sole Proprietor?:No
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00046811101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor