Provider Demographics
NPI:1770737157
Name:PAUL, JAN C (LMHC, CEAP, SAP)
Entity type:Individual
Prefix:MRS
First Name:JAN
Middle Name:C
Last Name:PAUL
Suffix:
Gender:F
Credentials:LMHC, CEAP, SAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7021 1ST AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-4802
Mailing Address - Country:US
Mailing Address - Phone:206-898-2312
Mailing Address - Fax:
Practice Address - Street 1:7021 1ST AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-4802
Practice Address - Country:US
Practice Address - Phone:206-898-2312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00006578101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health