Provider Demographics
NPI:1497310783
Name:SUNSERI, ZIA (MA, LMFTA, ASAT)
Entity Type:Individual
Prefix:
First Name:ZIA
Middle Name:
Last Name:SUNSERI
Suffix:
Gender:F
Credentials:MA, LMFTA, ASAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 VINE ST UNIT 604
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-5107
Mailing Address - Country:US
Mailing Address - Phone:206-701-0236
Mailing Address - Fax:
Practice Address - Street 1:1904 3RD AVE STE 315
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1126
Practice Address - Country:US
Practice Address - Phone:206-701-0236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-02
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60829425101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMG60829425OtherLMFTA LICENSE FROM WA STATE DEPT OF HEALTH TO PRACTICE AS A PSYCHOTHERAPIST