Provider Demographics
NPI:1871037994
Name:DOLPH, TIMOTHY MC KEE (CRISIS COUNSELOR)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:MC KEE
Last Name:DOLPH
Suffix:
Gender:M
Credentials:CRISIS COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25802 S 1998 PR SE # PRSE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-6351
Mailing Address - Country:US
Mailing Address - Phone:509-396-1455
Mailing Address - Fax:
Practice Address - Street 1:500 N. MORAIN ST. STE. 1250
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336
Practice Address - Country:US
Practice Address - Phone:509-783-0500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health