Provider Demographics
NPI:1205023488
Name:INGRAM-JONES, GUINEVEVA F (MA)
Entity Type:Individual
Prefix:MS
First Name:GUINEVEVA
Middle Name:F
Last Name:INGRAM-JONES
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:GWEN
Other - Middle Name:F
Other - Last Name:INGRAM-JONES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA
Mailing Address - Street 1:1700 WESTLAKE AVE N
Mailing Address - Street 2:SUITE 650
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-3012
Mailing Address - Country:US
Mailing Address - Phone:206-283-2220
Mailing Address - Fax:206-283-2223
Practice Address - Street 1:1700 WESTLAKE AVE N
Practice Address - Street 2:SUITE 650
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-3012
Practice Address - Country:US
Practice Address - Phone:206-283-2220
Practice Address - Fax:206-283-2223
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60421433106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist