Provider Demographics
NPI:1184471187
Name:DR. JENNIFER, PHD, PLLC
Entity type:Organization
Organization Name:DR. JENNIFER, PHD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:CATALDI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:425-679-9316
Mailing Address - Street 1:1700 NW GILMAN BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-5364
Mailing Address - Country:US
Mailing Address - Phone:425-679-9316
Mailing Address - Fax:
Practice Address - Street 1:1700 NW GILMAN BLVD STE 205
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5364
Practice Address - Country:US
Practice Address - Phone:425-679-9316
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty