Provider Demographics
NPI:1952549107
Name:WEST, LINDA LEE (MA)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEE
Last Name:WEST
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 SW OLD FARM RD.
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98367
Mailing Address - Country:US
Mailing Address - Phone:360-876-1707
Mailing Address - Fax:
Practice Address - Street 1:3209 SW OLD FARM RD
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98367-9259
Practice Address - Country:US
Practice Address - Phone:360-876-1707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-27
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005313101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health