Provider Demographics
NPI:1710589890
Name:LOY, JOSHUA (LMCH)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:LOY
Suffix:
Gender:M
Credentials:LMCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2110 NORTHLAKE AVE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-1355
Mailing Address - Country:US
Mailing Address - Phone:402-613-2718
Mailing Address - Fax:
Practice Address - Street 1:9900 WILLOWS RD NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-2531
Practice Address - Country:US
Practice Address - Phone:402-613-2718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60637078101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty