Provider Demographics
NPI:1801478151
Name:DONELSON, LAUREN EVELYN (LMFTA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:EVELYN
Last Name:DONELSON
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 4TH AVE # 2344
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-9997
Mailing Address - Country:US
Mailing Address - Phone:503-928-8965
Mailing Address - Fax:
Practice Address - Street 1:10930 FORBES CREEK DR APT S308
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-3859
Practice Address - Country:US
Practice Address - Phone:503-928-8965
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-26
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61140590106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist