Individual
MATTHEW PONSFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A.
Contact information
Practice address
1740 NW MAPLE ST STE 210, ISSAQUAH, WA 98027-8127
(206) 719-8230
Mailing address
1740 NW MAPLE ST STE 210, ISSAQUAH, WA 98027-8127
(206) 719-8230
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MC60679555
WA
103TC0700X
Clinical Psychologist
Primary
PY60769223
WA
Other
Enumeration date
07/14/2016
Last updated
03/17/2018
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