Provider Demographics
NPI:1467599639
Name:OMAITS, JANET C (LICSW)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:C
Last Name:OMAITS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12501 BEL RED RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2509
Mailing Address - Country:US
Mailing Address - Phone:425-451-1695
Mailing Address - Fax:425-649-9070
Practice Address - Street 1:12501 BEL RED RD
Practice Address - Street 2:SUITE 115
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2509
Practice Address - Country:US
Practice Address - Phone:425-451-1695
Practice Address - Fax:425-649-9070
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00005151104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
7758040OtherAETNA US HEALTHCARE
OM5621OtherREGENCE PIN