Doctor Name: | MICHAEL VAUGHN |
NPI Number: | 1700036399 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | LH00005701 |
Business Practice Address: | 6700 Totem Beach Rd Tulalip, WA - 982719714 |
Business Phone Number: | 3607164096 |
Business Fax Number: | |
Mailing Address: | 6700 Totem Beach Rd, TULALIP |
State: | WA |
Postal Code: | 982719714 |
Phone Number: | 3607164096 |
Fax Number: | |
NPI Enumeration Date: | 09/19/2008 |
NPI Last Update Date: | 07/22/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | LH00005701 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |