Provider Demographics
NPI:1184230500
Name:JANKUS, JEANNE MARIE (MFTA)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:MARIE
Last Name:JANKUS
Suffix:
Gender:F
Credentials:MFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16710 SMOKEY POINT BLVD STE 306
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8435
Mailing Address - Country:US
Mailing Address - Phone:360-421-0943
Mailing Address - Fax:
Practice Address - Street 1:16710 SMOKEY POINT BLVD STE 306
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8435
Practice Address - Country:US
Practice Address - Phone:260-421-9043
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-21
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61049650106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist