Provider Demographics
NPI:1013212596
Name:JAFFE, FREDDA (MS, LMFT)
Entity Type:Individual
Prefix:MS
First Name:FREDDA
Middle Name:
Last Name:JAFFE
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13030 MILITARY RD S
Mailing Address - Street 2:SUITE 202
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-3085
Mailing Address - Country:US
Mailing Address - Phone:206-310-4264
Mailing Address - Fax:206-479-7216
Practice Address - Street 1:13030 MILITARY RD S
Practice Address - Street 2:SUITE 202
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-3085
Practice Address - Country:US
Practice Address - Phone:206-310-4264
Practice Address - Fax:206-479-7216
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001680106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist