Provider Demographics
NPI:1265542609
Name:EMANUEL, JEAN SIGEL
Entity type:Individual
Prefix:
First Name:JEAN
Middle Name:SIGEL
Last Name:EMANUEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEAN
Other - Middle Name:LOUISE
Other - Last Name:EMANUEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:15436 BEL RED RD
Mailing Address - Street 2:STE 100
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-5536
Mailing Address - Country:US
Mailing Address - Phone:425-644-4100
Mailing Address - Fax:425-644-4101
Practice Address - Street 1:15436 BEL RED RD
Practice Address - Street 2:STE 100
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5536
Practice Address - Country:US
Practice Address - Phone:425-644-4100
Practice Address - Fax:425-644-4101
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00024506101Y00000X
WARN00051122163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0144423OtherL&I