Provider Demographics
NPI:1326774738
Name:RAMONDETTA, RACHEL KATHLEEN (LMFTA)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:KATHLEEN
Last Name:RAMONDETTA
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27484
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98165-2484
Mailing Address - Country:US
Mailing Address - Phone:253-316-2146
Mailing Address - Fax:
Practice Address - Street 1:1926 2ND AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1102
Practice Address - Country:US
Practice Address - Phone:425-954-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG61321546106H00000X
WA61321546106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMG61321546OtherDEPARTMENT OF HEALTH PROFESSIONAL LICENSE -ASSOCIATE MARRIAGE & FAMILY THERAPIST