Provider Demographics
NPI:1881008787
Name:TURNER, DENNIS (MM)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:
Last Name:TURNER
Suffix:
Gender:M
Credentials:MM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8819 25TH AVENUE CT S
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8307
Mailing Address - Country:US
Mailing Address - Phone:253-314-9242
Mailing Address - Fax:253-582-3856
Practice Address - Street 1:8819 25TH AVENUE CT S
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8307
Practice Address - Country:US
Practice Address - Phone:253-314-9242
Practice Address - Fax:253-582-3856
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA23323Medicaid