Provider Demographics
NPI:1790899391
Name:WEBSTER, JAMES P (STD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:WEBSTER
Suffix:
Gender:M
Credentials:STD
Other - Prefix:DR
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:WEBSTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:PO BOX 7629
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98417-0629
Mailing Address - Country:US
Mailing Address - Phone:253-593-3674
Mailing Address - Fax:253-272-0748
Practice Address - Street 1:4424 6TH AVE # 1-G
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-3506
Practice Address - Country:US
Practice Address - Phone:253-272-4557
Practice Address - Fax:253-272-0748
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001222106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist