Provider Demographics
NPI:1417916495
Name:JUNG, CAROL GRIFFIN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:GRIFFIN
Last Name:JUNG
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6745 W MERCER WAY
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-4859
Mailing Address - Country:US
Mailing Address - Phone:206-236-1959
Mailing Address - Fax:
Practice Address - Street 1:1325 4TH AVE
Practice Address - Street 2:SUITE 1345
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2573
Practice Address - Country:US
Practice Address - Phone:206-344-6855
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1475103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist