Provider Demographics
NPI:1619005428
Name:DAVIS, JUDY LEE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:JUDY
Middle Name:LEE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MISS
Other - First Name:JUDY
Other - Middle Name:LEE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2532 161ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-5423
Mailing Address - Country:US
Mailing Address - Phone:425-373-1389
Mailing Address - Fax:
Practice Address - Street 1:155 NE 100TH ST STE 402
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-8010
Practice Address - Country:US
Practice Address - Phone:206-523-1665
Practice Address - Fax:206-523-3019
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001697106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist