Provider Demographics
NPI:1912221243
Name:JINDRA, JUDITH (MED, LMFT)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:JINDRA
Suffix:
Gender:F
Credentials:MED, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12218 83RD PL NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-5819
Mailing Address - Country:US
Mailing Address - Phone:425-213-0709
Mailing Address - Fax:
Practice Address - Street 1:12218 83RD PL NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-5819
Practice Address - Country:US
Practice Address - Phone:425-213-0709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-15
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF 00000962101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health