Provider Demographics
NPI:1013289750
Name:EVERETT, FREDA ELAINE (MA)
Entity Type:Individual
Prefix:MS
First Name:FREDA
Middle Name:ELAINE
Last Name:EVERETT
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20907 114TH PL SE APT 32
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-1130
Mailing Address - Country:US
Mailing Address - Phone:206-683-5958
Mailing Address - Fax:
Practice Address - Street 1:20907 114TH PL SE APT 32
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98031-1130
Practice Address - Country:US
Practice Address - Phone:206-683-5958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health