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General NPI Number Information
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NPI Number | 1205230935
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Entity Type | Organization
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Legal Business Name | IKRON GREATER SEATTLE
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Dates
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Enumeration Date | 10/08/2014
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 3805 108TH AVE NE STE. 204
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City | BELLEVUE
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State | WA
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Zip | 98004-7613
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Country | US
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Telephone | 425-242-1713
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Fax |
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Provider Business Mailing Address
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Address Line | 3805 108TH AVE NE STE. 204
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City | BELLEVUE
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State | WA
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Zip | 98004-7613
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Country | US
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Telephone | 425-242-1713
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JENNIFER JEFFERIES
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Credential | MS, LMHC, MHP
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Telephone | 425-242-1713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 314
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 314
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License Number State | WA
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