Provider Demographics
NPI:1497143309
Name:DROUHARD STILLEY, GEMMA (MA, LMFT)
Entity Type:Individual
Prefix:
First Name:GEMMA
Middle Name:
Last Name:DROUHARD STILLEY
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11826 NE 141ST ST
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-1417
Mailing Address - Country:US
Mailing Address - Phone:253-720-6490
Mailing Address - Fax:
Practice Address - Street 1:17330 135TH AVE NE STE 2B
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-8522
Practice Address - Country:US
Practice Address - Phone:425-998-9769
Practice Address - Fax:844-837-1339
Is Sole Proprietor?:No
Enumeration Date:2014-12-30
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60746842106H00000X
106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist