Provider Demographics
NPI:1205089133
Name:WONG-MILLER, WAI E (MA LMHC)
Entity type:Individual
Prefix:
First Name:WAI
Middle Name:E
Last Name:WONG-MILLER
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:WAI
Other - Middle Name:E
Other - Last Name:WONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11014 39TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125
Mailing Address - Country:US
Mailing Address - Phone:206-788-4888
Mailing Address - Fax:
Practice Address - Street 1:10303 MERIDIAN AVE N
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-790-4888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-22
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 60264430101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health