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General NPI Number Information
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NPI Number | 1003403395
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Entity Type | Individual
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Provider Name | JEANETTE M KRAEMER LICSW
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Gender | Female
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Dates
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Enumeration Date | 12/21/2020
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Last Update Date | 11/05/2024
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Provider Practice Location Address
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Address Line | 7522 221ST PL SW
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City | EDMONDS
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State | WA
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Zip | 98026-8029
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Country | US
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Telephone | 425-775-4059
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Fax |
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Provider Business Mailing Address
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Address Line | 923 112TH ST SW APT B215
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City | EVERETT
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State | WA
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Zip | 98204-7868
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Country | US
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Telephone | 425-534-0947
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 61533643
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License Number State | WA
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