Individual
LUKE THAO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMFTA
Contact information
Practice address
12614 SE 223RD DR, KENT, WA 98031-9690
(253) 693-0041
Mailing address
12614 SE 223RD DR, KENT, WA 98031-9690
(253) 693-0041
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MG61133206
WA
106H00000X
Marriage & Family Therapist
Primary
MG61133206
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417532243
NPI
—
Enumeration date
09/23/2019
Last updated
03/10/2022
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