Provider Demographics
NPI:1720256183
Name:SIMON ONCKEN, JOAN S (LMFT)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:S
Last Name:SIMON ONCKEN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 198TH ST SW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-6738
Mailing Address - Country:US
Mailing Address - Phone:425-771-1914
Mailing Address - Fax:425-771-0127
Practice Address - Street 1:4215 198TH ST SW
Practice Address - Street 2:SUITE 102
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6738
Practice Address - Country:US
Practice Address - Phone:425-771-1914
Practice Address - Fax:425-771-0127
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00000836106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA243165OtherMHN
WA253936OtherVALUE OPTIONS
WA5777726OtherAETNA
WAON4514OtherREGENCE