Provider Demographics
NPI:1497881635
Name:COLE, JILL C (DSW)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:C
Last Name:COLE
Suffix:
Gender:F
Credentials:DSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 1ST AVE
Mailing Address - Street 2:SUITE 720
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-2158
Mailing Address - Country:US
Mailing Address - Phone:206-226-6873
Mailing Address - Fax:206-448-6945
Practice Address - Street 1:2025 1ST AVE
Practice Address - Street 2:SUITE 720
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2158
Practice Address - Country:US
Practice Address - Phone:206-226-6873
Practice Address - Fax:206-448-6945
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2009-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000057641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical