Basic Information
Provider Information
NPI: 1881063758
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EDMONDS
FirstName: ANNAH
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: LMHC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 12TH AVE S STE 901
Address2:  
City: SEATTLE
State: WA
PostalCode: 981442712
CountryCode: US
TelephoneNumber: 2065483058
FaxNumber: 2062620859
Practice Location
Address1: 1753 NW 56TH ST STE 200
Address2:  
City: SEATTLE
State: WA
PostalCode: 981075279
CountryCode: US
TelephoneNumber: 2067825939
FaxNumber: 2067825934
Other Information
ProviderEnumerationDate: 09/21/2015
LastUpdateDate: 08/20/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/20/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
101YM0800XLH61176981WAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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