Individual
SUSAN M DORN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFTA
Contact information
Practice address
6825 31ST AVE NE, SEATTLE, WA 98115-7244
(425) 517-9523
Mailing address
6825 31ST AVE NE, SEATTLE, WA 98115-7244
(425) 517-9523
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
61166216
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61166216
WA STATE DEPARTMENT OF HEALTH
WA
Enumeration date
08/23/2021
Last updated
08/23/2021
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