Provider Demographics
NPI:1407261019
Name:KIDANE, TSION (LMFTA)
Entity Type:Individual
Prefix:
First Name:TSION
Middle Name:
Last Name:KIDANE
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 1:1116 NW 54TH ST
Mailing Address - Street 2:APT # 203
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3750
Mailing Address - Country:US
Mailing Address - Phone:206-234-6249
Mailing Address - Fax:
Practice Address - Street 1:11320 ROOSEVELT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6228
Practice Address - Country:US
Practice Address - Phone:206-234-6249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG 60408946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health