Provider Demographics
NPI:1750576765
Name:GLADE, AARON CHRISTOPHER (PHD, LMFT)
Entity type:Individual
Prefix:DR
First Name:AARON
Middle Name:CHRISTOPHER
Last Name:GLADE
Suffix:
Gender:M
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 114TH AVE SE
Mailing Address - Street 2:110
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6903
Mailing Address - Country:US
Mailing Address - Phone:206-327-1190
Mailing Address - Fax:425-329-7966
Practice Address - Street 1:11417 124TH AVE NE
Practice Address - Street 2:SUITE 204
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-4677
Practice Address - Country:US
Practice Address - Phone:425-889-0832
Practice Address - Fax:425-827-6221
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-12
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002605106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist