Provider Demographics
NPI:1558834960
Name:WINDLEHARTH, JUDITH MONIQUE
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:MONIQUE
Last Name:WINDLEHARTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12542 5TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-3901
Mailing Address - Country:US
Mailing Address - Phone:425-655-7925
Mailing Address - Fax:
Practice Address - Street 1:12542 5TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-3901
Practice Address - Country:US
Practice Address - Phone:425-655-7925
Practice Address - Fax:425-655-7949
Is Sole Proprietor?:No
Enumeration Date:2019-01-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61192830101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health