Provider Demographics
NPI:1609108331
Name:HUETTIG, LESTER SHELTON (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:LESTER
Middle Name:SHELTON
Last Name:HUETTIG
Suffix:
Gender:M
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 1:4221 34TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1307
Mailing Address - Country:US
Mailing Address - Phone:206-325-6167
Mailing Address - Fax:
Practice Address - Street 1:2808 - II EAST MADISON ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4862
Practice Address - Country:US
Practice Address - Phone:206-302-8830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-05
Last Update Date:2010-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001481106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist