Provider Demographics
NPI:1215094370
Name:ELTON, JENNIFER MARIE (MS, LMFT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:MARIE
Last Name:ELTON
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:MISS
Other - First Name:JENNFIER
Other - Middle Name:MARIE
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LMFT
Mailing Address - Street 1:918 ALDER AVE
Mailing Address - Street 2:
Mailing Address - City:SUMNER
Mailing Address - State:WA
Mailing Address - Zip Code:98390-1406
Mailing Address - Country:US
Mailing Address - Phone:253-826-6626
Mailing Address - Fax:
Practice Address - Street 1:918 ALDER AVE
Practice Address - Street 2:
Practice Address - City:SUMNER
Practice Address - State:WA
Practice Address - Zip Code:98390-1406
Practice Address - Country:US
Practice Address - Phone:253-826-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001768106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist