Doctor Name: | MR. DOUGLAS FRASER GRAHAM |
NPI Number: | 1033138334 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | LH00003684 |
Business Practice Address: | 23800 Se Kent Kangley Rd Maple Valley, WA - 980386848 |
Business Phone Number: | 2069011185 |
Business Fax Number: | |
Mailing Address: | 16425 266th Ave Se, ISSAQUAH |
State: | WA |
Postal Code: | 980276936 |
Phone Number: | 2069011185 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH00003684 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |