Provider Demographics
NPI:1235342213
Name:JANIS C. RASMUSSEN, PSYD, PS
Entity Type:Organization
Organization Name:JANIS C. RASMUSSEN, PSYD, PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:RASMUSSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:425-347-7275
Mailing Address - Street 1:127 E INTERCITY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-2751
Mailing Address - Country:US
Mailing Address - Phone:425-347-7275
Mailing Address - Fax:
Practice Address - Street 1:127 E INTERCITY AVE STE A
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-2751
Practice Address - Country:US
Practice Address - Phone:425-347-7275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
8857997Medicare ID - Type Unspecified