Basic Information
| Provider Information | |||||||||
| NPI: | 1790899391 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WEBSTER | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | S.T.D. | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | WEBSTER | ||||||||
| OtherFirstName: | JIM | ||||||||
| OtherMiddleName: | |||||||||
| OtherNamePrefix: | DR. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | LMFT | ||||||||
| OtherLastNameType: | 2 | ||||||||
| Mailing Information | |||||||||
| Address1: | 1901 S. UNION AVE. | ||||||||
| Address2: | SUITE B-7006 | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984051807 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532724557 | ||||||||
| FaxNumber: | 2535934818 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 S UNION AVE | ||||||||
| Address2: | SUITE B-7006 | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984051702 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532724557 | ||||||||
| FaxNumber: | 2535934818 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | LH00004798 | WA | X | Behavioral Health & Social Service Providers | Counselor | Mental Health | 106H00000X | LF00001222 | WA | X | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.