Provider Demographics
NPI:1861847402
Name:RASMUSSEN, LACIE (LMFT)
Entity Type:Individual
Prefix:
First Name:LACIE
Middle Name:
Last Name:RASMUSSEN
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 1:3684 NE PIONEER ST
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-7498
Mailing Address - Country:US
Mailing Address - Phone:503-893-9114
Mailing Address - Fax:
Practice Address - Street 1:3684 NE PIONEER ST
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-7498
Practice Address - Country:US
Practice Address - Phone:503-893-9114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-02
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist