Provider Demographics
NPI:1861960825
Name:MACDONALD, LINDA JEAN (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:JEAN
Last Name:MACDONALD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10612 65TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-8675
Mailing Address - Country:US
Mailing Address - Phone:253-310-1550
Mailing Address - Fax:253-858-2254
Practice Address - Street 1:10612 65TH AVE NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-8675
Practice Address - Country:US
Practice Address - Phone:253-310-1550
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-08
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001029106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1336216423OtherNPPES