Provider Demographics
NPI:1740320118
Name:POWELL, STEVEN DAVID (MA)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:DAVID
Last Name:POWELL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9395 LINDER WAY NW STE 201
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-9149
Mailing Address - Country:US
Mailing Address - Phone:206-799-7951
Mailing Address - Fax:360-692-6458
Practice Address - Street 1:9395 LINDER WAY NW STE 201
Practice Address - Street 2:
Practice Address - City:SILVERDALE
Practice Address - State:WA
Practice Address - Zip Code:98383-9149
Practice Address - Country:US
Practice Address - Phone:206-799-7951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2023-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0000001317106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist