Provider Demographics
NPI:1417168436
Name:HORIKE, JANIS T (PHD)
Entity Type:Individual
Prefix:DR
First Name:JANIS
Middle Name:T
Last Name:HORIKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 114TH AVE SE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6950
Mailing Address - Country:US
Mailing Address - Phone:425-452-0306
Mailing Address - Fax:425-635-0405
Practice Address - Street 1:1601 114TH AVE SE
Practice Address - Street 2:SUITE 107
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6950
Practice Address - Country:US
Practice Address - Phone:425-452-0306
Practice Address - Fax:425-635-0405
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA562103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral