Provider Demographics
NPI:1871894923
Name:WATT, JAMES WALTER (CERTIFIED COUNSELOR)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WALTER
Last Name:WATT
Suffix:
Gender:M
Credentials:CERTIFIED COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1309 LENORE DR
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-1821
Mailing Address - Country:US
Mailing Address - Phone:253-381-3459
Mailing Address - Fax:253-650-2000
Practice Address - Street 1:1309 LENORE DR
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-1821
Practice Address - Country:US
Practice Address - Phone:253-381-3459
Practice Address - Fax:253-650-2000
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-05
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACL60145803101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor