Provider Demographics
NPI:1568710481
Name:TURNBULL, JANE ELLEN (PSYD, MED)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:ELLEN
Last Name:TURNBULL
Suffix:
Gender:F
Credentials:PSYD, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13824 N CREEK DR
Mailing Address - Street 2:UNIT 801
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-2068
Mailing Address - Country:US
Mailing Address - Phone:206-445-8784
Mailing Address - Fax:
Practice Address - Street 1:2230 RUCKER AVE
Practice Address - Street 2:SUITE 1C
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-2772
Practice Address - Country:US
Practice Address - Phone:206-445-8784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60291493101YM0800X
WA60313605103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health