Provider Demographics
NPI:1780672857
Name:HUENEFELD GESE, NANCY (PHD)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:
Last Name:HUENEFELD GESE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:HUENEFELD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 1974
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98009-1974
Mailing Address - Country:US
Mailing Address - Phone:425-495-2609
Mailing Address - Fax:425-458-9059
Practice Address - Street 1:4315 FACTORIA BLVD SE
Practice Address - Street 2:STE B
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98006-1930
Practice Address - Country:US
Practice Address - Phone:425-495-2609
Practice Address - Fax:425-458-9059
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002345103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Provider Identifiers
StateIdentifier IDID TypeIssuer
AB26311Medicare ID - Type Unspecified