Provider Demographics
NPI:1194975789
Name:NEW FAMILY TRADITIONS
Entity type:Organization
Organization Name:NEW FAMILY TRADITIONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRESHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CDP
Authorized Official - Phone:206-762-7207
Mailing Address - Street 1:9045 16TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-2355
Mailing Address - Country:US
Mailing Address - Phone:206-762-7207
Mailing Address - Fax:206-762-7980
Practice Address - Street 1:9045 16TH AVE SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98106-2355
Practice Address - Country:US
Practice Address - Phone:206-762-7207
Practice Address - Fax:206-762-7980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-19
Last Update Date:2008-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA17141600251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health