MEDICARE: MRS. ANNA JANNACK BFA, MA, LMHC, ATR

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
1	101Y00000X	Counselor	LH60734918	WA

General Provider Information

NPI Number	:	1033513106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANNA JANNACK BFA, MA, LMHC, ATR

Provider Business Mailing Address
First Line	:	3258 CALIFORNIA AVE SW STE B
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-3358
Country	:	US
Telephone Number	:	206-474-9708
Fax Number	:

Provider Business Practice Location Address
First Line	:	3258 CALIFORNIA AVE SW STE B
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98116-3358
Country	:	US
Telephone Number	:	206-474-9708
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2014
Last Update Date	:	09/08/2021

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