Provider Demographics
NPI:1790230795
Name:KEPTNER, JANE (SWAIC)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:KEPTNER
Suffix:
Gender:F
Credentials:SWAIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23001 LAKEVIEW DR
Mailing Address - Street 2:UNIT 106
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-2371
Mailing Address - Country:US
Mailing Address - Phone:585-978-2871
Mailing Address - Fax:
Practice Address - Street 1:10700 MERIDIAN AVE N
Practice Address - Street 2:SUITE G-11
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-9008
Practice Address - Country:US
Practice Address - Phone:206-366-3042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC605804911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical