Provider Demographics
NPI:1649550419
Name:SODERQUIST-BELL, MAE MARIE (MA, COUNSELING)
Entity type:Individual
Prefix:MRS
First Name:MAE
Middle Name:MARIE
Last Name:SODERQUIST-BELL
Suffix:
Gender:F
Credentials:MA, COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11802 NE 117TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-1560
Mailing Address - Country:US
Mailing Address - Phone:360-891-2000
Mailing Address - Fax:360-944-6965
Practice Address - Street 1:11802 NE 117TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-1560
Practice Address - Country:US
Practice Address - Phone:360-891-2000
Practice Address - Fax:360-944-6965
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60154712101Y00000X, 101YM0800X, 101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist