Provider Demographics
NPI:1942200217
Name:FISHER, DALE J (LMHC)
Entity Type:Individual
Prefix:MS
First Name:DALE
Middle Name:J
Last Name:FISHER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 OLYMPIA AVE NE UNIT 26
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-4119
Mailing Address - Country:US
Mailing Address - Phone:425-255-4331
Mailing Address - Fax:425-255-3310
Practice Address - Street 1:401 OLYMPIA AVE NE UNIT 26
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-4119
Practice Address - Country:US
Practice Address - Phone:425-255-4331
Practice Address - Fax:425-255-3311
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006438101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health