Provider Demographics
NPI:1639876329
Name:JET CITY PSYCHOLOGICAL SERVICES, PLLC
Entity Type:Organization
Organization Name:JET CITY PSYCHOLOGICAL SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JANELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAINTER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:206-414-9498
Mailing Address - Street 1:3500 SW ALASKA ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-2731
Mailing Address - Country:US
Mailing Address - Phone:206-414-9498
Mailing Address - Fax:
Practice Address - Street 1:3500 SW ALASKA ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-2731
Practice Address - Country:US
Practice Address - Phone:206-414-9498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1285861377OtherNPI