Provider Demographics
NPI:1811163439
Name:STIMMEL, DAVID BEN (MS)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BEN
Last Name:STIMMEL
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:BEN
Other - Middle Name:
Other - Last Name:STIMMEL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:1101 BROADWAY ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3268
Mailing Address - Country:US
Mailing Address - Phone:360-771-1509
Mailing Address - Fax:888-808-8143
Practice Address - Street 1:1101 BROADWAY ST
Practice Address - Street 2:SUITE 230
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3268
Practice Address - Country:US
Practice Address - Phone:360-771-1509
Practice Address - Fax:888-808-8143
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-03
Last Update Date:2013-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00002510106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist