Most Relevant Information
Provider Data
| NPI Number: | 1003415779 |
| Provider Name: | MATTHEW L WALD |
| Entity Type: | Individual |
| Taxonomy Code: | 101Y00000X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/22/2020 |
| Last Updated: | 10/22/2020 |
Provider Practice Location
122 16TH AVE E
SEATTLE
WA
981125212
Practice Location Phone/Fax
| Phone: | 2063022700 |
| Fax: |
Provider Mailing Location
6400 SOUTHCENTER BLVD
TUKWILA
WA
981882547
Provider Mailing Phone/Fax
| Phone: | 2069012000 |
| Fax: |