Provider Demographics
NPI:1215656103
Name:VALADES, JIMENA
Entity type:Individual
Prefix:
First Name:JIMENA
Middle Name:
Last Name:VALADES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16241 6TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-3734
Mailing Address - Country:US
Mailing Address - Phone:206-372-1396
Mailing Address - Fax:
Practice Address - Street 1:1035 SW 124TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98146-2746
Practice Address - Country:US
Practice Address - Phone:206-817-0298
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health