Provider Demographics
NPI:1962827261
Name:TRAN, JOHN (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:TRAN
Suffix:
Gender:M
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:KIM-JOHN
Other - Middle Name:
Other - Last Name:TRAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, LMHC
Mailing Address - Street 1:1812 E MADISON ST
Mailing Address - Street 2:#202
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2843
Mailing Address - Country:US
Mailing Address - Phone:206-617-2338
Mailing Address - Fax:
Practice Address - Street 1:1812 E MADISON ST
Practice Address - Street 2:#202
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2843
Practice Address - Country:US
Practice Address - Phone:206-617-2338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-23
Last Update Date:2014-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60450943101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health