Provider Demographics
NPI:1710095617
Name:NASH, MARY S (LMFT)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:S
Last Name:NASH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 454
Mailing Address - Street 2:
Mailing Address - City:OLGA
Mailing Address - State:WA
Mailing Address - Zip Code:98279-0454
Mailing Address - Country:US
Mailing Address - Phone:360-317-6166
Mailing Address - Fax:360-376-6182
Practice Address - Street 1:1286 BAKER RD.
Practice Address - Street 2:SUITE 8
Practice Address - City:EASTSOUND
Practice Address - State:WA
Practice Address - Zip Code:98245-8057
Practice Address - Country:US
Practice Address - Phone:360-317-6166
Practice Address - Fax:360-376-6182
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00001425106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist