Provider Demographics
NPI:1972889095
Name:MCTIGHE, TIMOTHY WILLIAM (LMFCT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:WILLIAM
Last Name:MCTIGHE
Suffix:
Gender:M
Credentials:LMFCT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19001 VASHON HWY SW, SUITE 205
Mailing Address - Street 2:
Mailing Address - City:VASHON
Mailing Address - State:WA
Mailing Address - Zip Code:98070-5214
Mailing Address - Country:US
Mailing Address - Phone:206-919-1150
Mailing Address - Fax:
Practice Address - Street 1:19001 VASHON HWY SW, SUITE 205
Practice Address - Street 2:
Practice Address - City:VASHON
Practice Address - State:WA
Practice Address - Zip Code:98070-5214
Practice Address - Country:US
Practice Address - Phone:206-919-1150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LF00001016106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist