Provider Demographics
NPI:1972761922
Name:INMAN, LORAN SHAD (LMHC)
Entity Type:Individual
Prefix:MR
First Name:LORAN
Middle Name:SHAD
Last Name:INMAN
Suffix:
Gender:M
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:PO BOX 2016
Mailing Address - Street 2:
Mailing Address - City:ORTING
Mailing Address - State:WA
Mailing Address - Zip Code:98360
Mailing Address - Country:US
Mailing Address - Phone:260-271-1294
Mailing Address - Fax:253-845-7073
Practice Address - Street 1:3908 10TH ST SE
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374
Practice Address - Country:US
Practice Address - Phone:253-286-4211
Practice Address - Fax:253-845-7073
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-27
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00007383101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health