Active NPI
Wilder Heath, MA, LMFT
- Marriage & Family Therapist
- Kirkland, WA
National Provider Identifier
1649657149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MG60467470
- Practice address
- 12025 115TH Ave NE Ste 200
Kirkland, WA 98034-6935 - Phone
- (425) 821-1810
- NPI assigned
- May 4, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LAMFT-5546T | AZ | |
| Marriage & Family Therapist | 106H00000X | MG60467470 | WA | Primary |
Addresses
Primary practice location
12025 115TH Ave NE Ste 200
Kirkland, WA 98034-6935
Mailing address
12025 115TH Ave NE Ste 200
Kirkland, WA 98034-6935
Phone (425) 821-1810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAMFT-5546T | AZ | MD | Marriage & Family Therapist |
| MG60467470 | WA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlantic Street Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Seattle, WA
- NPI 1447551221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1430697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572480000000",
"number": "1649657149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12025 115TH AVE NE STE 200",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980346935",
"telephone_number": "425-821-1810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12025 115TH AVE NE STE 200",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980346935",
"telephone_number": "425-821-1810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEATH",
"first_name": "WILDER",
"name_prefix": "Mr.",
"credential": "MA, LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-05-04",
"last_updated": "2019-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "AZ",
"license": "LAMFT-5546T",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "MG60467470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.