Provider Demographics
NPI:1518666999
Name:BOLIN, NEFETERIA LOUISE (BA, MA)
Entity Type:Individual
Prefix:
First Name:NEFETERIA
Middle Name:LOUISE
Last Name:BOLIN
Suffix:
Gender:F
Credentials:BA, MA
Other - Prefix:
Other - First Name:NEFATERIA
Other - Middle Name:LOUISE
Other - Last Name:BOLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BA, MA
Mailing Address - Street 1:4501 RAINIER AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-1656
Mailing Address - Country:US
Mailing Address - Phone:206-536-7011
Mailing Address - Fax:
Practice Address - Street 1:4501 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-1656
Practice Address - Country:US
Practice Address - Phone:206-536-7011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist