MEDICARE: DR. JODI ANN PALMER PSY.D., LMHC

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	101YM0800X	Mental Health Counselor	LH60310029	WA

General Provider Information

NPI Number	:	1851645352
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JODI ANN PALMER PSY.D., LMHC

Provider Business Mailing Address
First Line	:	737 OLIVE WAY
Second Line	:	APT 2608
City	:	SEATTLE
State	:	WA
Zip	:	98101-3743
Country	:	US
Telephone Number	:	213-618-1036
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 WESTLAKE AVE N
Second Line	:	SUITE 650
City	:	SEATTLE
State	:	WA
Zip	:	98109-3012
Country	:	US
Telephone Number	:	206-283-2220
Fax Number	:

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

Provider Enumeration Date	:	11/05/2012
Last Update Date	:	11/05/2012

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