MR. WILDER HEATH (NPI# 1649657149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649657149 |
| Entity Type | Individual |
| Full Name | MR. WILDER HEATH |
| Credential | MA, LMFT |
| Practice Address |
12025 115th Ave Ne Ste 200 Kirkland WA 98034-6935 |
| Practice Telephone | 4258211810 |
| Mailing Telephone | 4258211810 |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2019-10-31 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 106H00000X | Marriage & Family Therapist | LAMFT-5546T | AZ | Behavioral Health & Social Service Providers |
| Y | 106H00000X | Marriage & Family Therapist | MG60467470 | WA | Behavioral Health & Social Service Providers |
| Street Address |
12025 115TH AVE NE STE 200 |
| City | KIRKLAND |
| State | WA |
| Zip Code | 98034-6935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356790430 | Lisa Marie Hoffman Hasse | Counselor | 12025 115th Ave Ne Ste 200, Kirkland, WA 98034-6935 | 2016-06-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116596 | Rachel Bowers | Behavior Technician | 1335 Northeast 122nd Way, Suite 105, Kirkland, WA 98034 | 2019-07-18 |
| 1740841048 | Kristina Louise Inghram | Behavior Technician | 11415 Ne 128th St., Suite 40, Kirkland, WA 98034 | 2019-06-26 |
| 1053978064 | Matthew A. Bagnulo, Dds, Ps | Dentist | 11830 Ne 128th St., #202, Kirkland, WA 98034 | 2019-05-24 |
| 1629568928 | Stephanie Michalko | Optometrist | 11800 Ne 128th St Ste 110, Kirkland, WA 98034 | 2018-05-14 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1891202834 | Barbara Josephine Gorham | Counselor | 2025 115th Ave Ne, Bldg D, #200, Kirkland, WA 98034 | 2017-12-29 |
| 1548782915 | Eleanor Hollis Wall | Counselor | 14340 102nd Ave Ne, Kirkland, WA 98034 | 2017-07-07 |
| 1457885212 | Peter Schoonmaker | Hospitalist | 12040 Ne 128th Street, Ms105, Kirkland, WA 98034 | 2017-04-18 |
| 1780124370 | Rebecca Managan | Advanced Practice Midwife | 12303 Ne 130th Ln Ste Coral225, Kirkland, WA 98034 | 2017-03-01 |
| 1669821104 | Winter Gonzalez | Counselor | 11720 97th Ln Ne Apt A411, Kirkland, WA 98034 | 2016-06-06 |
| Find all providers in zip 98034 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174163679 | Loryann Mariam Nichols | Marriage & Family Therapist | 11417 124th Ave Ne Ste 204, Kirkland, WA 98033-4677 | 2020-01-13 |
| 1790254407 | United Trauma Center | Marriage & Family Therapist | 9757 Ne Juanita Dr Ste 206b, Kirkland, WA 98034-4268 | 2018-11-26 |
| 1952800013 | Heath Family Counseling LLC | Marriage & Family Therapist | 12025 115th Ave. Ne, Building D, Ste 200, Kirkland, WA 98034 | 2018-02-05 |
| 1245753649 | Sarah H Dellinger | Marriage & Family Therapist | 10512 Ne 68th St Ste 200, Kirkland, WA 98033-7002 | 2017-07-18 |
| 1851823595 | Kelly Johnerson | Marriage & Family Therapist | 11002 122nd Ln Ne, Apt K82, Kirkland, WA 98033-4690 | 2017-03-31 |
| 1982089017 | Meryl Henry | Marriage & Family Therapist | 150 Lake St S Ste 222, Kirkland, WA 98033-6461 | 2015-07-30 |
| 1497143309 | Gemma Drouhard Stilley | Marriage & Family Therapist | 9757 Ne Juanita Dr Ste 206, Kirkland, WA 98034 | 2014-12-30 |
| 1346597366 | Kelsey Devoille | Marriage & Family Therapist | 5740 127th Ave Ne, Kirkland, WA 98033-8741 | 2012-08-09 |
| 1740401520 | Amy M Abramson Rinde | Marriage & Family Therapist | 10839 Ne 112th St, Kirkland, WA 98033-4507 | 2007-05-01 |
| 1083830566 | Ronald William Shosten | Marriage & Family Therapist | 516 6th St S, Suite 106, Kirkland, WA 98033-6727 | 2007-04-17 |
| Find all providers in KIRKLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.