Provider Demographics
NPI:1619188992
Name:SORENSEN, ANETTE (MED, BCBA)
Entity Type:Individual
Prefix:
First Name:ANETTE
Middle Name:
Last Name:SORENSEN
Suffix:
Gender:F
Credentials:MED, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7012 EARL AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117
Mailing Address - Country:US
Mailing Address - Phone:206-922-3896
Mailing Address - Fax:206-922-3726
Practice Address - Street 1:7012 EARL AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-5939
Practice Address - Country:US
Practice Address - Phone:206-922-3896
Practice Address - Fax:206-922-3726
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor