Provider Demographics
NPI:1619147154
Name:MATTHEW, CYNTHIA K (CDSIII)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:K
Last Name:MATTHEW
Suffix:
Gender:F
Credentials:CDSIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33309 1ST WAY S
Mailing Address - Street 2:STE 203
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6260
Mailing Address - Country:US
Mailing Address - Phone:253-952-2556
Mailing Address - Fax:253-952-6356
Practice Address - Street 1:33309 1ST WAY S
Practice Address - Street 2:STE 203
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6260
Practice Address - Country:US
Practice Address - Phone:253-952-2556
Practice Address - Fax:253-952-6356
Is Sole Proprietor?:No
Enumeration Date:2008-03-11
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00000700101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)