Individual
MAKAEL LEE WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFT, ATR-BC
Contact information
Practice address
447 25TH AVE, LONGVIEW, WA 98632-1321
(253) 290-3762
Mailing address
447 25TH AVE, LONGVIEW, WA 98632-1321
(253) 290-3762
(253) 390-3033
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF61328543
WA
221700000X
Art Therapist
20-217
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2250928
—
WA
Enumeration date
07/11/2022
Last updated
01/13/2025
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