Individual
DAVID FAGERHOLM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED,MHP, LMHCA, NCC
Contact information
Practice address
122 16TH AVE E, SEATTLE, WA 98112-5212
(206) 302-2700
Mailing address
1600 E OLIVE ST, SEATTLE, WA 98122-2735
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MC 60612129
WA
Other
Enumeration date
09/18/2014
Last updated
07/22/2016
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