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NPI Code Detail

MEDICARE: FOR A CHILD, LLC

MEDICARE: FOR A CHILD, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC2200XClinical Child & Adolescent PsychologistPY00002482WA

General Provider Information

NPI Number : 1780886341
Entity Type Code : Organization
Provider Name (Legal Business Name) : FOR A CHILD, LLC
Provider Business Mailing Address
First Line : 5224 WILSON AVE S
Second Line : SUITE 101A
City : SEATTLE
State : WA
Zip : 98118-2587
Country : US
Telephone Number : 206-725-1820
Fax Number : 206-725-1890
Provider Business Practice Location Address
First Line : 5224 WILSON AVE S
Second Line : SUITE 101A
City : SEATTLE
State : WA
Zip : 98118-2587
Country : US
Telephone Number : 206-725-1820
Fax Number : 206-725-1890
Authorized Official
Title or Position : OWNER
Name : DR. JANINE JONES
Credential : PHD
Telephone Number : 206-725-1820
Provider Enumeration Date : 06/04/2007
Last Update Date : 08/22/2020

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Directions to “FOR A CHILD, LLC ” Practice Location

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