Basic Information
Provider Information
NPI: 1922540814
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STRAUSS
FirstName: ASHLEY
MiddleName: J.
NamePrefix:  
NameSuffix:  
Credential: PSYD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 3835
Address2:  
City: SEATTLE
State: WA
PostalCode: 981243835
CountryCode: US
TelephoneNumber: 2065483114
FaxNumber: 2067626355
Practice Location
Address1: 4400 37TH AVE S
Address2:  
City: SEATTLE
State: WA
PostalCode: 981181609
CountryCode: US
TelephoneNumber: 2064616957
FaxNumber: 2064617810
Other Information
ProviderEnumerationDate: 11/09/2016
LastUpdateDate: 04/05/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XLH60704247WAN Behavioral Health & Social Service ProvidersCounselorMental Health
103TC0700XPY60771837WAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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