Polly Frances Fields, LMFT

Individual provider Active NPI Marriage & Family Therapist · Buckley, WA

NPI 1831497833 · NPPES record last updated Mar 1, 2011

Key facts

NPI
1831497833
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LF00001313 (WA)
Practice address
23711 Entwhistle Rd E
Buckley, WA 98321-8485
Phone
(253) 862-2163
Fax
(253) 862-7527
NPI assigned
Mar 1, 2011
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LF00001313WAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LF00001313 WA Yes

Addresses

Primary practice location

23711 Entwhistle Rd E
Buckley, WA 98321-8485

Mailing address

23711 Entwhistle Rd E
Buckley, WA 98321-8485
Phone (253) 862-2163

Other identifiers

IdentifierTypeStateIssuer
600179-119OtherWAUBI

Other providers in Buckley, WA

All providers in Buckley, WA · Marriage & Family Therapist in Washington

Sources for this page

Verify at the official NPI Registry.