Provider Demographics
NPI:1881905123
Name:STAR, JAMIE LEE (MHP, LMHCA)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LEE
Last Name:STAR
Suffix:
Gender:F
Credentials:MHP, LMHCA
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:LEE
Other - Last Name:FREEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21222 133RD ST NE
Mailing Address - Street 2:
Mailing Address - City:GRANITE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:98252-8531
Mailing Address - Country:US
Mailing Address - Phone:425-512-6855
Mailing Address - Fax:
Practice Address - Street 1:221 AVENUE B
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2840
Practice Address - Country:US
Practice Address - Phone:425-349-7285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-01
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60382495101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health