Provider Demographics
NPI:1184080483
Name:DANNER, KIMBERLY RAYE (LMFT, MHP)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:RAYE
Last Name:DANNER
Suffix:
Gender:F
Credentials:LMFT, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8275 166TH AVE NE STE 200
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6629
Mailing Address - Country:US
Mailing Address - Phone:425-869-2644
Mailing Address - Fax:425-867-0930
Practice Address - Street 1:8275 166TH AVE NE STE 102
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-6629
Practice Address - Country:US
Practice Address - Phone:425-869-2644
Practice Address - Fax:425-867-0930
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60916484106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist