Provider Demographics
NPI:1730471541
Name:WIEBE, ROBYN J (LMHC)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:J
Last Name:WIEBE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16405 53RD PL S
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-3200
Mailing Address - Country:US
Mailing Address - Phone:253-861-1662
Mailing Address - Fax:253-896-1123
Practice Address - Street 1:1120 114TH AVE E
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98372-1413
Practice Address - Country:US
Practice Address - Phone:253-896-0903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60161207101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health