Provider Demographics
NPI:1407205628
Name:PRIZONT, EVELYN S (LMFTA)
Entity Type:Individual
Prefix:
First Name:EVELYN
Middle Name:S
Last Name:PRIZONT
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 1:4850 S JUNEAU ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-2848
Mailing Address - Country:US
Mailing Address - Phone:206-914-9037
Mailing Address - Fax:
Practice Address - Street 1:4850 S JUNEAU ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-2848
Practice Address - Country:US
Practice Address - Phone:206-914-9037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-08
Last Update Date:2016-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60648475106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist