Provider Demographics
NPI:1518036599
Name:VANDERLINDA, RICHARD E (MA)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:E
Last Name:VANDERLINDA
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:RICK
Other - Middle Name:E
Other - Last Name:VANDERLINDA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT & LMHC
Mailing Address - Street 1:6123 51ST STREET CT W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98467-4124
Mailing Address - Country:US
Mailing Address - Phone:253-564-4572
Mailing Address - Fax:253-564-8091
Practice Address - Street 1:3501 S ORCHARD ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98466-6735
Practice Address - Country:US
Practice Address - Phone:253-564-4572
Practice Address - Fax:253-564-8091
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001661106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist