Provider Demographics
NPI:1952072159
Name:FLOTHE, JARED OLIN (LMHC)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:OLIN
Last Name:FLOTHE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 WELLS ST
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-3512
Mailing Address - Country:US
Mailing Address - Phone:425-432-8182
Mailing Address - Fax:
Practice Address - Street 1:2010 WELLS ST
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-3512
Practice Address - Country:US
Practice Address - Phone:425-432-8182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60247095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health