Individual
MAILE GRACE DAVELAAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT
Contact information
Practice address
10090 MAIN ST APT H, PESHASTIN, WA 98847-9770
(509) 676-6009
(509) 676-6009
Mailing address
9041 DERBY CANYON RD, PESHASTIN, WA 98847-9754
(509) 679-8749
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
LF60195205
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2050159
—
WA
Enumeration date
08/23/2010
Last updated
10/15/2018
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