Provider Demographics
NPI:1982974242
Name:FAIR, TIMI B (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:TIMI
Middle Name:B
Last Name:FAIR
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8306 8TH AVE NW
Mailing Address - Street 2:TIMI B. FAIR, PSYCHOTHERAPY
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3219
Mailing Address - Country:US
Mailing Address - Phone:206-706-2830
Mailing Address - Fax:
Practice Address - Street 1:5306 BALLARD AVE NW STE 322
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-4366
Practice Address - Country:US
Practice Address - Phone:206-706-2839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-04
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60372344101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WALH60372344OtherWASHINGTON DEPARTMENT OF HEALTH
WALH60372344OtherWASHINGTON DEPARTMENT OF HEALTH