Provider Demographics
NPI:1942798236
Name:KUEHNEMANN, ELAINE THERESE (CN, LMHC)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:THERESE
Last Name:KUEHNEMANN
Suffix:
Gender:F
Credentials:CN, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 MILLER AVE # 273
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-1903
Mailing Address - Country:US
Mailing Address - Phone:415-302-3651
Mailing Address - Fax:
Practice Address - Street 1:727 N 68TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5319
Practice Address - Country:US
Practice Address - Phone:262-844-4999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-23
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANU60519634133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist