Provider Demographics
NPI:1821318171
Name:LOUDON, MARY DIANNE PLUMMER (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:DIANNE PLUMMER
Last Name:LOUDON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:DIANNE
Other - Last Name:PLUMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1700 WESTLAKE AVE. N.
Mailing Address - Street 2:SUITE 400
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-6263
Mailing Address - Country:US
Mailing Address - Phone:206-769-2052
Mailing Address - Fax:
Practice Address - Street 1:1700 WESTLAKE AVE. N.
Practice Address - Street 2:SUITE 400
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-6263
Practice Address - Country:US
Practice Address - Phone:206-769-2052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-09
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60063635103TC0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical