Provider Demographics
NPI:1629408232
Name:CALLAHAN, ASHLEY (LMFTA)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 GALER ST APT 242
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-3398
Mailing Address - Country:US
Mailing Address - Phone:206-240-1486
Mailing Address - Fax:206-780-2740
Practice Address - Street 1:2004 FAIRVIEW AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-2704
Practice Address - Country:US
Practice Address - Phone:206-240-1486
Practice Address - Fax:206-240-2740
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2013-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMG60408327106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist