Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP1600X | Pastoral Counselor | RC52217 | WA |
NPI | 1174680276 |
---|---|
Provider Name | Marie Terese Matteson |
First Address | Bellingham, WA 98225-4004 |
Second Address | Bellingham, WA 98225-4004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 06/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
HP60104589 | STATE OF WASHINGTON DOH (01) | WA |
MA10351 | LIC MASSAGE PRACTITIIONER (01) | WA |
RC52217 | REGISTERED COUNSELOR (01) | WA |