Provider Demographics
NPI:1336500065
Name:FOSS SWAINE, JEANNE (LMFT)
Entity Type:Individual
Prefix:
First Name:JEANNE
Middle Name:
Last Name:FOSS SWAINE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8213 ASHWORTH AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-4434
Mailing Address - Country:US
Mailing Address - Phone:415-702-8231
Mailing Address - Fax:
Practice Address - Street 1:2021 MINOR AVE E
Practice Address - Street 2:SUITE #2
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3588
Practice Address - Country:US
Practice Address - Phone:415-702-8231
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60558963106H00000X
CA84479106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist