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General NPI Number Information
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NPI Number | 1518196534
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Entity Type | Individual
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Provider Name | JILL T. CZADEK BHA
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Gender | Female
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Dates
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Enumeration Date | 07/12/2009
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Last Update Date | 07/12/2009
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Provider Practice Location Address
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Address Line | 201 LILA LN
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City | BURLINGTON
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State | WA
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Zip | 98233-3320
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Country | US
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Telephone | 360-419-7539
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Fax | 360-757-8729
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Provider Business Mailing Address
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Address Line | 24805 47TH AVE NE
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City | ARLINGTON
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State | WA
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Zip | 98223-7280
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Country | US
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Telephone |
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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 | RC60026563
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License Number State | WA
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