Provider Demographics
NPI:1750650685
Name:MATHEWS, LAURA (LMFT)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MATHEWS
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 1:1200 WESTLAKE AVE N
Mailing Address - Street 2:SUITE 901
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-3543
Mailing Address - Country:US
Mailing Address - Phone:206-774-9419
Mailing Address - Fax:
Practice Address - Street 1:1200 WESTLAKE AVE N
Practice Address - Street 2:SUITE 901
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-3543
Practice Address - Country:US
Practice Address - Phone:206-774-9419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60427925106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist