Provider Demographics
NPI:1932523099
Name:KATZ, JAMIE
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:KATZ
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 1:3622 13TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98144-7308
Mailing Address - Country:US
Mailing Address - Phone:206-819-1472
Mailing Address - Fax:
Practice Address - Street 1:1127 10TH AVE E
Practice Address - Street 2:SUITE #3
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-4377
Practice Address - Country:US
Practice Address - Phone:206-819-1472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH602301071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical