Provider Demographics
NPI:1164082947
Name:AGASSIZ, WHITNEY (LMHCA)
Entity Type:Individual
Prefix:MRS
First Name:WHITNEY
Middle Name:
Last Name:AGASSIZ
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19117 RICHMOND BEACH DR NW
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-2941
Mailing Address - Country:US
Mailing Address - Phone:206-719-2173
Mailing Address - Fax:
Practice Address - Street 1:200 1ST AVE W STE 312
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98119-4219
Practice Address - Country:US
Practice Address - Phone:206-719-2173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-14
Last Update Date:2019-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60948355101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health