Basic Information
| Provider Information | |||||||||
| NPI: | 1255003968 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | DAWN | ||||||||
| MiddleName: | CHARISSE | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LMFTA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3506 SW 325TH ST | ||||||||
| Address2: | |||||||||
| City: | FEDERAL WAY | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980232676 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2536700479 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3560 BRIDGEPORT WAY W STE 2C | ||||||||
| Address2: | |||||||||
| City: | UNIVERSITY PLACE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984664446 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534607248 | ||||||||
| FaxNumber: | 2535644409 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/30/2021 | ||||||||
| LastUpdateDate: | 09/30/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | MG61212213 | WA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.