Provider Demographics
NPI:1043572951
Name:JUSTICE, ANNAMICHELLE
Entity Type:Individual
Prefix:MS
First Name:ANNAMICHELLE
Middle Name:
Last Name:JUSTICE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5802 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2706
Mailing Address - Country:US
Mailing Address - Phone:206-723-1980
Mailing Address - Fax:206-721-3930
Practice Address - Street 1:5802 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2706
Practice Address - Country:US
Practice Address - Phone:206-723-1980
Practice Address - Fax:206-721-3930
Is Sole Proprietor?:No
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60150261101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor