Provider Demographics
NPI:1235305335
Name:FRIEDLANDER, KELLI LYNN STUECKLE
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:LYNN STUECKLE
Last Name:FRIEDLANDER
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 1:1309 114TH AVE SE
Mailing Address - Street 2:BELLEFIELD OFFICE PARK SUITE 316
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:425-453-1311
Mailing Address - Fax:
Practice Address - Street 1:1309 114TH AVE SE
Practice Address - Street 2:STE 316
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6903
Practice Address - Country:US
Practice Address - Phone:425-453-1311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health