Provider Demographics
NPI:1609386663
Name:FRIEDLAND, BETH ELLEN (MS, MA)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ELLEN
Last Name:FRIEDLAND
Suffix:
Gender:F
Credentials:MS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18909 101ST AVE NE APT 6
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3876
Mailing Address - Country:US
Mailing Address - Phone:510-717-2100
Mailing Address - Fax:
Practice Address - Street 1:20102 CEDAR VALLEY RD STE 201
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-6333
Practice Address - Country:US
Practice Address - Phone:425-312-1340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-04
Last Update Date:2017-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005873101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health