Provider Demographics
NPI:1922123264
Name:RASMUSSEN, JANIS CAROL (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JANIS
Middle Name:CAROL
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 E INTERCITY AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-2732
Mailing Address - Country:US
Mailing Address - Phone:425-347-7275
Mailing Address - Fax:425-355-0626
Practice Address - Street 1:127 E INTERCITY AVE
Practice Address - Street 2:SUITE A
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208
Practice Address - Country:US
Practice Address - Phone:425-347-7275
Practice Address - Fax:425-355-0626
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1491103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical