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General NPI Number Information
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NPI Number | 1134425184
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Entity Type | Individual
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Provider Name | MR. JONATHAN MICHAEL ADERHOLD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2011
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Last Update Date | 01/24/2020
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Provider Practice Location Address
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Address Line | 3414 1/2 FREMONT AVENUE N SUITE D
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City | SEATTLE
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State | WA
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Zip | 98103
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Country | US
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Telephone | 206-472-9297
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Fax | 888-965-5143
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Provider Business Mailing Address
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Address Line | 3414 1/2 FREMONT AVENUE N SUITE D
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City | SEATTLE
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State | WA
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Zip | 98103
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Country | US
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Telephone | 206-472-9297
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Fax | 888-965-5143
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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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