Provider Demographics
NPI:1578326708
Name:MCGUIRE, KIMBERLY CHEYENNE MARIE (MS, LMFT-A)
Entity Type:Individual
Prefix:MISS
First Name:KIMBERLY
Middle Name:CHEYENNE MARIE
Last Name:MCGUIRE
Suffix:
Gender:F
Credentials:MS, LMFT-A
Other - Prefix:
Other - First Name:CHEYENNE
Other - Middle Name:
Other - Last Name:MCGUIRE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1200 WESTLAKE AVE N STE 407
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-3528
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1200 WESTLAKE AVE N STE 407
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-3528
Practice Address - Country:US
Practice Address - Phone:806-853-7230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61421506106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist