Ted Vidan, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LF00002345 Issued in WA

Practice address

29633 Marine View Dr SW
Federal Way, WA 98023-3400

Phone

(253) 945-1004

Fax

(253) 945-1004

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1508809849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29633 MARINE VIEW DR SW",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980233400",
            "telephone_number": "253-945-1004",
            "fax_number": "253-945-1004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29633 MARINE VIEW DR SW",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980233400",
            "telephone_number": "253-945-1004",
            "fax_number": "253-945-1004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDAN",
        "first_name": "TED",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WA",
            "license": "LF00002345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "216458",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Marriage & Family Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.