Provider Demographics
NPI:1811439078
Name:INGHAM, FREDERICK LOKER (MA, LMHCA)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:LOKER
Last Name:INGHAM
Suffix:
Gender:M
Credentials:MA, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 26TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-3044
Mailing Address - Country:US
Mailing Address - Phone:206-403-5062
Mailing Address - Fax:
Practice Address - Street 1:1500 FAIRVIEW AVE E STE 205
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3727
Practice Address - Country:US
Practice Address - Phone:206-403-5062
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60601474101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health