Provider Demographics
NPI:1962666859
Name:MAGEE-SALEM, GERALDINE ANN (BA, MA, LMFTA)
Entity Type:Individual
Prefix:MRS
First Name:GERALDINE
Middle Name:ANN
Last Name:MAGEE-SALEM
Suffix:
Gender:F
Credentials:BA, MA, LMFTA
Other - Prefix:MR
Other - First Name:GERI
Other - Middle Name:
Other - Last Name:SALEM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:6212 75TH ST W
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8368
Mailing Address - Country:US
Mailing Address - Phone:253-439-0130
Mailing Address - Fax:
Practice Address - Street 1:6212 75TH ST W
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8368
Practice Address - Country:US
Practice Address - Phone:253-439-0130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2009-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00056394101Y00000X
WAMG60126429106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor