Provider Demographics
NPI:1437813912
Name:FICKES, JEFFERY JAY (MA)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY
Middle Name:JAY
Last Name:FICKES
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 31ST AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-2556
Mailing Address - Country:US
Mailing Address - Phone:206-229-3457
Mailing Address - Fax:
Practice Address - Street 1:206 31ST AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-2556
Practice Address - Country:US
Practice Address - Phone:206-229-3457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-29
Last Update Date:2021-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health