Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | MC 60293349 | WA |
NPI | 1003207481 |
---|---|
Provider Name | Peter P Jabin |
First Address | Seattle, WA 98102-4557 |
Second Address | Seattle, WA 98104-3595 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2015 |
Last Update Date | 06/02/2015 |