Provider Demographics
NPI:1841306941
Name:CHAMBERLAIN, MATTHEW H (MA LMFT)
Entity type:Individual
Prefix:MR
First Name:MATTHEW
Middle Name:H
Last Name:CHAMBERLAIN
Suffix:
Gender:M
Credentials:MA LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2743 NE 98TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2449
Mailing Address - Country:US
Mailing Address - Phone:206-910-0625
Mailing Address - Fax:206-367-8284
Practice Address - Street 1:6523 21ST AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-6924
Practice Address - Country:US
Practice Address - Phone:206-910-0625
Practice Address - Fax:206-367-8284
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001364106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist