Provider Demographics
NPI:1205984390
Name:PINEDO, MYRNA ELAINE (LMHC)
Entity type:Individual
Prefix:DR
First Name:MYRNA
Middle Name:ELAINE
Last Name:PINEDO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:DR
Other - First Name:MYRNA
Other - Middle Name:ELAINE
Other - Last Name:PINEDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT
Mailing Address - Street 1:1611 116TH AVE NE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3045
Mailing Address - Country:US
Mailing Address - Phone:425-453-1234
Mailing Address - Fax:425-453-8222
Practice Address - Street 1:1611 116TH AVE NE
Practice Address - Street 2:SUITE 103
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3045
Practice Address - Country:US
Practice Address - Phone:425-453-1234
Practice Address - Fax:425-453-8222
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH 5320101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health