Provider Demographics
NPI:1790193647
Name:JAHNKE, GAIL SUZAN (MSW)
Entity Type:Individual
Prefix:
First Name:GAIL
Middle Name:SUZAN
Last Name:JAHNKE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:854 SUZANNE CT
Mailing Address - Street 2:
Mailing Address - City:LANGLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98260-8631
Mailing Address - Country:US
Mailing Address - Phone:425-351-2174
Mailing Address - Fax:
Practice Address - Street 1:854 SUZANNE CT
Practice Address - Street 2:
Practice Address - City:LANGLEY
Practice Address - State:WA
Practice Address - Zip Code:98260-8631
Practice Address - Country:US
Practice Address - Phone:425-351-2174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-23
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
WALW000063881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical