Provider Demographics
NPI:1871253682
Name:VONHEEDER-PHILLIPS, GRETCHEN IONE FRY (MSW, LICSW)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:IONE FRY
Last Name:VONHEEDER-PHILLIPS
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:IONE FRY
Other - Last Name:VONHEEDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:4800 SAND POINT WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-3901
Mailing Address - Country:US
Mailing Address - Phone:206-987-1507
Mailing Address - Fax:
Practice Address - Street 1:4800 SAND POINT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-3901
Practice Address - Country:US
Practice Address - Phone:206-987-1507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-20
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health