Provider Demographics
NPI:1477854792
Name:MOWAT, DEBRA S (MA PHD LMHC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:S
Last Name:MOWAT
Suffix:
Gender:F
Credentials:MA PHD LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6513 132ND AVE NE # 151
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8628
Mailing Address - Country:US
Mailing Address - Phone:425-785-9362
Mailing Address - Fax:
Practice Address - Street 1:11502 NE 20TH ST
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3005
Practice Address - Country:US
Practice Address - Phone:425-785-9362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60163793101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health