Provider Demographics
NPI:1629615760
Name:WAIAMAU-ARIOTA, JESSIE JEAN (LMHC)
Entity Type:Individual
Prefix:
First Name:JESSIE
Middle Name:JEAN
Last Name:WAIAMAU-ARIOTA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33003 47TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3212
Mailing Address - Country:US
Mailing Address - Phone:850-384-2702
Mailing Address - Fax:
Practice Address - Street 1:WINDS OF LIBERTY
Practice Address - Street 2:702 S HILL PARK DR STE 206
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373
Practice Address - Country:US
Practice Address - Phone:253-770-5956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60837200101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health