Provider Demographics
NPI:1639299084
Name:ROSS, JANET GRAHAM (CALIFORNIA MFCC13290)
Entity Type:Individual
Prefix:MS
First Name:JANET
Middle Name:GRAHAM
Last Name:ROSS
Suffix:
Gender:F
Credentials:CALIFORNIA MFCC13290
Other - Prefix:MRS
Other - First Name:JANET
Other - Middle Name:LOUISE
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 FIRST AVENUE
Mailing Address - Street 2:SUITE #625
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104
Mailing Address - Country:US
Mailing Address - Phone:206-223-1411
Mailing Address - Fax:
Practice Address - Street 1:600 FIRST AVENUE
Practice Address - Street 2:SUITE 625
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-223-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACMHC30000362101YM0800X
WACMFTMF20000341106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist